Individual
DR. DANIEL O. ODEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
825 NICOLLET MALL, SUITE 1001, MINNEAPOLIS, MN 55402
(612) 332-2618
Mailing address
825 NICOLLET MALL, SUITE 1001, MINNEAPOLIS, MN 55402
(612) 332-2618
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7836
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
495-717-200
MINN MEDICAL ASSISTANCE
MN
Enumeration date
02/05/2008
Last updated
02/05/2008
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