Individual
DR. BETH ANN GAVREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
15785 95TH AVE N, MAPLE GROVE, MN 55369-4404
(763) 233-4141
(763) 420-5875
Mailing address
15785 95TH AVE N, MAPLE GROVE, MN 55369-4404
(763) 233-4141
(763) 420-5875
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D11463
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8068330-00
—
MN
Enumeration date
10/14/2005
Last updated
06/28/2013
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