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Individual

DR. SAUL OVALLE

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
212 STAR ST, MANKATO, MN 56001-4825
(507) 387-4078
(507) 387-4055
Mailing address
2110 BURNETT LN, NORTH MANKATO, MN 56003-1661
(507) 387-8220

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D11727
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41730WA
BLUE PLUS GROUP NUMBER
MN
Enumeration date
10/11/2005
Last updated
07/08/2007
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