Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | D8509 | MN |
N | 1223D0001X | Dental Public Health | D8509 | MN |
NPI | 1578587754 |
---|---|
Provider Name | Dr. Donald Patrick Nierengarten |
First Address | Sartell, MN 56377-1538 |
Second Address | Saint Cloud, MN 56303-2015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |