Individual
CHEYTON HOMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDT
Contact information
Practice address
8401 W BROADWAY AVE, BROOKLYN PARK, MN 55445-2266
(763) 424-5313
Mailing address
8401 W BROADWAY AVE, BROOKLYN PARK, MN 55445-2266
(763) 424-5313
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT172
MN
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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