Individual
DR. ROY VERNON HAKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 143N, SAINT PAUL, MN 55114-1052
(651) 642-1013
(651) 642-0947
Mailing address
2550 UNIVERSITY AVE W, SUITE 143N, SAINT PAUL, MN 55114-1052
(651) 642-1013
(651) 642-0947
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8171
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1491470
TAX ID #
MN
05
—
33662100
—
WI
01
—
D8171
MINNESOTA DENTAL LICENSE
MN
Enumeration date
09/29/2006
Last updated
09/20/2013
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