Individual
SIMONA AWISZUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1026 7TH ST W, SAINT PAUL, MN 55102-3828
(651) 758-9500
Mailing address
1026 7TH ST W, SAINT PAUL, MN 55102-3828
(651) 758-9500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11716
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610021000
MEDICAL ASST PROVIDER #
MN
Enumeration date
03/29/2006
Last updated
12/17/2024
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