Individual
BRADLY DONABAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
310 S BROADWAY, CROOKSTON, MN 56716-1913
(218) 281-1301
Mailing address
310 S BROADWAY, CROOKSTON, MN 56716-1913
(218) 281-1301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11563
MN
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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