Individual
DR. THEODORE MARK DANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14700 28TH AVE N STE 20, PLYMOUTH, MN 55447-4876
(763) 559-3779
(763) 450-3986
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
2482206
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
2488
MN
Other
Enumeration date
05/30/2020
Last updated
06/29/2020
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