Provider Demographics
NPI:1144587080
Name:TESFAHUN, ASMERET (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASMERET
Middle Name:
Last Name:TESFAHUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 SYNDICATE ST N SUITE 300
Mailing Address - Street 2:HEALTHPARTNERS MIDWAY DENTAL CLINIC
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4107
Mailing Address - Country:US
Mailing Address - Phone:651-254-7373
Mailing Address - Fax:651-254-7383
Practice Address - Street 1:450 SYNDICATE ST N SUITE 300
Practice Address - Street 2:HEALTHPARTNERS MIDWAY DENTAL CLINIC
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4107
Practice Address - Country:US
Practice Address - Phone:651-254-7373
Practice Address - Fax:651-254-7383
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13108122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist