Organization
TRAVIS PRUNTY DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS ANDREW PRUNTY (DDS)
(507) 388-3023
Entity
Organization
Contact information
Practice address
730 E MADISON AVE, MANKATO, MN 56001-6100
(507) 388-3023
(507) 388-3353
Mailing address
PO BOX 894, MANKATO, MN 56002-0894
(507) 388-3023
(507) 388-3353
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12552
MN
Other
Enumeration date
08/06/2008
Last updated
08/06/2008
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