Individual
DR. PREM KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3803 SILVER LAKE RD NE, MINNEAPOLIS, MN 55421-4574
(612) 782-7000
Mailing address
11301 FOUNTAINS DR, MAPLE GROVE, MN 55369-7200
(763) 762-7177
(763) 762-7177
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12142
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
937605400
MEDICAL ASSISTANCE NUMBER
MN
Enumeration date
01/19/2007
Last updated
03/25/2020
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