NPI 1023107224

Thomas J Diem, DDSMD

Practitioner Specialist Fridley, MN

Practice location

Address: 500 Osborne Rd NE Unity Professional Bldg Suite 350, Fridley, MN 55432-2765
Phone: (763) 780-8927
Fax: (763) 780-1286
Mailing address: 12010 53rd Ave N, Plymouth, MN 55442-1834

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 24664 (MN)

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Registry record

NPI: 1023107224
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Oct 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.