Individual
MALINA TEODORU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13550 26TH AVE N, PLYMOUTH, MN 55441-3650
(763) 557-0287
(763) 557-0295
Mailing address
14376 ASPEN AVE NE, PRIOR LAKE, MN 55372-1307
(952) 992-0282
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D12674
MN
1223G0001X
General Practice Dentistry
Primary
D12674
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D12674
MN BOARD OF DENTISTRY
MN
Enumeration date
06/26/2009
Last updated
02/17/2015
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