Individual
DANIEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7280 E POINT DOUGLAS RD S, COTTAGE GROVE, MN 55016-3016
(651) 458-7002
Mailing address
7280 E POINT DOUGLAS RD S, COTTAGE GROVE, MN 55016-3016
(651) 458-7002
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
123676
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
123676
STATE LICENSE NUMBER
MN
Enumeration date
10/09/2020
Last updated
10/09/2020
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