Individual
DR. BENJAPORN KRUBSACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
515 DELAWARE ST SE, 6-320 MOOS HEALTH SCIENCE TOWER, MINNEAPOLIS, MN 55455
(612) 626-0140
(612) 626-0138
Mailing address
515 DELAWARE ST SE, 6-320 MOOS TOWER, MINNEAPOLIS, MN 55455
(612) 626-0140
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033897
IL
1223X2210X
Orofacial Pain Dentistry
R785
MN
Other
Enumeration date
05/27/2021
Last updated
07/21/2022
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