Individual
DR. CLINT M DWORSHAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
5534 LAKELAND AVE N, CRYSTAL, MN 55429-3121
(763) 259-0188
(888) 636-9971
Mailing address
16908 SADDLEWOOD TRL, MINNETONKA, MN 55345-2672
(952) 935-9227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
117076-4
MN
183500000X
Pharmacist
4803
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117076-4
MN PHARMACIST LICENSE
MN
01
—
4803
ND PHARMACIST LICENSE
ND
Enumeration date
05/21/2007
Last updated
03/30/2009
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