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Individual

THEODORE JAMES DEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA STUDENT

Contact information

Practice address
6612 GOLDEN RIDGE DR, EDEN PRAIRIE, MN 55344-3201
(952) 807-7262
Mailing address
6612 GOLDEN RIDGE DR, EDEN PRAIRIE, MN 55344-3201
(952) 807-7262

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
05/29/2025
Last updated
05/29/2025
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