Provider Demographics
NPI:1770315202
Name:FURMAN, MARIA JESUS (DDS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:JESUS
Last Name:FURMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:JESUS
Other - Last Name:LOPEZ MELENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:515 DELAWARE ST SE STE 15-116
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0357
Mailing Address - Country:US
Mailing Address - Phone:612-626-9695
Mailing Address - Fax:
Practice Address - Street 1:515 DELAWARE ST SE STE 15-116
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455-0357
Practice Address - Country:US
Practice Address - Phone:612-626-9695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH11793124Q00000X
MNFL70122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No124Q00000XDental ProvidersDental Hygienist