Provider Demographics
NPI:1356749659
Name:TODAY'S DENTAL
Entity type:Organization
Organization Name:TODAY'S DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BONAVENTURE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:763-710-9937
Mailing Address - Street 1:7960 BROOKLYN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2722
Mailing Address - Country:US
Mailing Address - Phone:763-710-9937
Mailing Address - Fax:
Practice Address - Street 1:7960 BROOKLYN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2722
Practice Address - Country:US
Practice Address - Phone:763-710-9937
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND129601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty