Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | D8051 | MN |
NPI | 1609844760 |
---|---|
Provider Name | Dr. Daniel Joseph Gatto |
First Address | Dellwood, MN 55110-1404 |
Second Address | Woodbury, MN 55125-4883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T39349 | (02) | MN |