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Individual

DR. ABDOLLAH RAHIMI

Active
Sole proprietor

Provider details

NPI number
Gender
Man

Contact information

Practice address
15600 36TH AVE N, SUITE 100, PLYMOUTH, MN 55446-3369
(763) 559-7688
(763) 559-2237
Mailing address
15600 36TH AVE N, SUITE 100, PLYMOUTH, MN 55446-3369
(763) 559-7688
(763) 559-2237

Taxonomy

Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
D10465
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01006428
PREFERRED ONE
MN
01
52D14RA
BLUE CROSS BLUE SHIELD
MN
01
86-24115
MEDICA
MN
Enumeration date
09/12/2005
Last updated
07/08/2007
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