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General NPI Number Information
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NPI Number | 1477378636
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Entity Type | Organization
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Legal Business Name | REGENTS OF THE UNIVERSITY OF MINNESOTA
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 701 25TH AVE S STE 400
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1443
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Country | US
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Telephone | 612-626-4232
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Fax |
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Provider Business Mailing Address
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Address Line | 515 DELAWARE ST SE 7-521 MOOS TOWER
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City | MINNEAPOLIS
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State | MN
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Zip | 55455-0357
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Country | US
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Telephone | 612-659-4900
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Fax |
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Authorized Official
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Title or Position | DEAN
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Name | KEITH MAYS
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Credential | DDS
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Telephone | 612-624-2424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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