Individual
OVADIA BENCIONOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11975 PORTLAND AVE STE 100, BURNSVILLE, MN 55337-1530
(832) 782-7813
Mailing address
11975 PORTLAND AVE STE 100, BURNSVILLE, MN 55337-1530
(832) 782-7813
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
BC788528
MN
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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