Individual
BRIA KAISER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MDT
Contact information
Practice address
12936 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 559-3400
Mailing address
12936 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 559-3400
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT42
MN
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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