Aesthetic-Reconstructive Plastic Surgery, Ltd
Specialist in Fridley, MN. Organization (NPI-2).
NPI number1801080353
StatusActive
Last updated in NPPESAug 28, 2007
Details
- NPI
- 1801080353
- Entity type
- Organization (NPI-2)
- Legal business name
- Aesthetic-Reconstructive Plastic Surgery, Ltd
- Organization subpart
- No
- Enumeration date
- Aug 28, 2007
- Last updated
- Aug 28, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 24664 | MN | Yes |
Practice location
500 Osborne Rd NeUnity Professional Bldg Suite 350
Fridley, MN 55432-2765
Phone 763-780-8927
Mailing address
500 Osborne Rd NeUnity Professional Bldg Suite 350
Fridley, MN 55432-2765
Authorized official
Thomas J Diem
Dr/Owner
7637808927
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All 20 Specialist providers in Fridley · All 1,234 providers in Fridley
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