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Individual

DMYTRO TERTYTSKYI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7701 YORK AVE S STE 240, EDINA, MN 55435-5896
(651) 505-5900
Mailing address
9460 ULYSSES ST NE APT 320, MINNEAPOLIS, MN 55434-3502
(646) 659-4428

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D15072
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/15/2024
Last updated
08/16/2025
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