Individual
DOMINIC JOSEPH GAGNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
616 4TH ST NE, STAPLES, MN 56479
(218) 894-2201
Mailing address
616 4TH ST NE, STAPLES, MN 56479-2273
(218) 894-2201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12933
MN
Other
Enumeration date
07/18/2011
Last updated
08/04/2018
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