Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 124Q00000X | Dental Hygienist | H6853 | MN |
NPI | 1043464035 |
---|---|
Provider Name | Neal Irion |
First Address | Coon Rapids, MN 55433-5852 |
Second Address | Coon Rapids, MN 55433-5852 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 03/06/2019 |