Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | D14525 | MN |
NPI | 1003481797 |
---|---|
Provider Name | Dr. Rajdeep Batth |
First Address | Minneapolis, MN 55414-2743 |
Second Address | Maplewood, MN 55109-1227 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2021 |
Last Update Date | 28/10/2021 |