Individual
DR. SUSAN GAIL PENNISTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3401 HIGHWAY 169 N, PLYMOUTH, MN 55441-2413
(763) 559-0859
(763) 550-4356
Mailing address
3401 HIGHWAY 169 N, PLYMOUTH, MN 55441-2413
(763) 559-0859
(763) 550-4356
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
10752
MN
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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