Most Relevant Information
Provider Data
| NPI Number: | 1003482217 |
| Provider Name: | JOANNA CHRISTINE BOURAIN DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 122300000X |
| Specialty: | Dentist |
| License Number: | D14545 |
Most Important Dates
| Enumeration Date: | 05/28/2021 |
| Last Updated: | 05/28/2021 |
Provider Practice Location
1313 PENN AVE N
MINNEAPOLIS
MN
554113047
Practice Location Phone/Fax
| Phone: | 8057290090 |
| Fax: |
Provider Mailing Location
2315 LONG AVE
SAINT PAUL
MN
551141248
Provider Mailing Phone/Fax
| Phone: | 8057290090 |
| Fax: |