Provider Demographics
NPI:1245973817
Name:DENTAL MANAGEMENT PARTNERS LLC
Entity type:Organization
Organization Name:DENTAL MANAGEMENT PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARIF
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZIR
Authorized Official - Suffix:
Authorized Official - Credentials:BDS
Authorized Official - Phone:763-231-2050
Mailing Address - Street 1:10210 BALTIMORE ST NE STE 100
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-6050
Mailing Address - Country:US
Mailing Address - Phone:763-231-2050
Mailing Address - Fax:
Practice Address - Street 1:10210 BALTIMORE ST NE STE 100
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-6050
Practice Address - Country:US
Practice Address - Phone:763-231-2050
Practice Address - Fax:763-231-2052
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLAINE DENTAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-20
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X2210XDental ProvidersDentistOrofacial PainGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
No261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial SurgeryGroup - Single Specialty