Al Shifa Dentistry PA

Organization Active NPI Dental Clinic/Center · Maple Grove, MN

NPI 1760703151 · NPPES record last updated Jun 19, 2010

Key facts

NPI
1760703151
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
License
D12215 (MN)
Legal business name
AL SHIFA DENTISTRY PA
Practice address
12936 63Rd Ave N
Maple Grove, MN 55369-6001
Phone
(763) 559-3400
Fax
(763) 559-3900
NPI assigned
Jun 19, 2010
Organization subpart
No

Authorized official

Name
Dr. Nasir Latif
Title
President
Phone
(612) 481-1976

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

12936 63rd Ave N
Maple Grove, MN 55369
Phone (763) 559-3400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D12215 MN Yes

Addresses

Primary practice location

12936 63Rd Ave N
Maple Grove, MN 55369-6001

Mailing address

12936 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (763) 559-3400

Other providers in Maple Grove, MN

All providers in Maple Grove, MN · Dental Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.