Travis Prunty Dds Pllc

NPI 1235395476 - Clinic/Center - 261QD0000X

NPI Details
NPI 1235395476
Enumeration Date 08/06/2008
Last Updated 08/06/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TRAVIS ANDREW TRAVIS
Position DDS
Phone (507) 388-3023
Fax (507) 388-3353
Practice Location
730 E MADISON AVE
MANKATO MN, 56001-6100, US
Phone (507) 388-3023
Fax (507) 388-3353
Business Location
PO BOX 894
MANKATO MN, 56002-0894, US
Phone (507) 388-3023
Fax (507) 388-3353
Toxanomy
Taxonomy Code 261QD0000X
License State Minnesota
License Number D12552
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According to our database, Travis Prunty Dds Pllc NPI is 1235395476, taxonomy code is 261QD0000X and license number is D12552, license state is located at Minnesota. Travis Prunty Dds Pllc physically located at 730 E Madison Ave, Mankato MN, 56001-6100. NPI Number 1033115704 has the healthcare provider type.

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1235395476 NPI number is provided on an as is basis without warranty of any kind. 1235395476 is maintained by the National Plan & Provider Enumeration System. The contents of Travis Prunty Dds Pllc are for informational purposes only.