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Organization

AUTHENTIC PLASTIC SURGERY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAWEL STACHOWICZ MD (MD)
(612) 360-6466
Entity
Organization

Contact information

Practice address
2000 PLYMOUTH ROAD, SUITE 300, MINNETONKA, MN 55305-2335
(612) 360-6466
Mailing address
2000 PLYMOUTH ROAD, SUITE 260, MINNETONKA, MN 55305-2335
(612) 360-6466

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary

Other

Enumeration date
09/12/2012
Last updated
11/12/2012
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