Individual
MS. SUANNE MARIE DULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
100 PINETREE DR, BIGFORK, MN 56628
(218) 743-3707
(218) 743-4218
Mailing address
56184 FARM CAMP RD, BIGFORK, MN 56628-4251
(218) 743-3202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9965
MN
Other
Enumeration date
06/03/2006
Last updated
07/08/2007
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