Individual
MR. KENT CJ DALZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
(507) 284-0702
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
(507) 284-0702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9648
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200822000
—
MN
05
—
ENROLLED
—
MN
Enumeration date
12/27/2005
Last updated
04/27/2009
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