Individual
DR. KETA BHAKTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13551 BALSAM LN N, DAYTON, MN 55327-9464
(763) 422-1714
Mailing address
524 98TH LN NE, BLAINE, MN 55434-1354
(612) 388-0595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D13212
MN
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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