Individual
DR. LYLE ARRIAN CORPUZ CARLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
12737 ELM CREEK BLVD N, MAPLE GROVE, MN 55369-7045
(763) 218-7005
Mailing address
2905 HARRIET AVE APT 107, MINNEAPOLIS, MN 55408-1651
(808) 597-4908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14046
MN
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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