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General NPI Number Information
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NPI Number | 1790967958
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Entity Type | Individual
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Provider Name | BASHAR ALKABBANI D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 06/29/2020
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Provider Practice Location Address
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Address Line | 6545 FRANCE AVE S STE 681
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City | EDINA
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State | MN
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Zip | 55435-2127
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Country | US
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Telephone | 612-800-8008
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Fax | 612-354-3015
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Provider Business Mailing Address
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Address Line | 6545 FRANCE AVE S STE 681
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City | EDINA
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State | MN
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Zip | 55435-2127
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Country | US
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Telephone | 612-800-8008
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Fax | 612-354-3015
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D12472
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License Number State | MN
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