Organization
SIDKY FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAYDI ROBEIR SIDKY DDS (OWNER / DENTIST)
(952) 405-8838
Entity
Organization
Contact information
Practice address
557 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-5379
(952) 405-8838
Mailing address
557 PRAIRIE CENTER DR, EDEN PRAIRIE, MN 55344-5379
(952) 405-8838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12056
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
988179400
—
MN
Enumeration date
01/23/2009
Last updated
01/23/2009
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