Provider Demographics
NPI:1124709928
Name:VOHRA, FAHIM (PHD)
Entity type:Individual
Prefix:DR
First Name:FAHIM
Middle Name:
Last Name:VOHRA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17795 32ND PL N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-1692
Mailing Address - Country:US
Mailing Address - Phone:612-986-1774
Mailing Address - Fax:
Practice Address - Street 1:515 DELAWARE ST SE,
Practice Address - Street 2:SCHOOL OF DENTISTRY
Practice Address - City:MINEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-986-1774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNFL661223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics