Individual
DALE J DUTHOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4786 BANNING AVE, WHITE BEAR LAKE, MN 55110-3264
(651) 426-6402
(651) 429-3402
Mailing address
2025 SLOAN PL STE 35, SAINT PAUL, MN 55117-2092
(651) 772-1572
(651) 772-1889
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27120
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
645567100
—
MN
Enumeration date
07/29/2006
Last updated
10/17/2019
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