Individual
KALLIE DELVEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1632 WASHINGTON ST NE, MINNEAPOLIS, MN 55413-1336
(612) 789-2853
Mailing address
2900 UNIVERSITY AVE SE APT 203, MINNEAPOLIS, MN 55414-3733
(309) 706-2829
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14201
MN
Other
Enumeration date
05/17/2019
Last updated
05/17/2019
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