Individual
JONATHAN DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
18901 62ND AVE N, MAPLE GROVE, MN 55311-4675
(917) 780-8719
Mailing address
18901 62ND AVE N, MAPLE GROVE, MN 55311-4675
(917) 780-8719
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
073930
GA
208600000X
Surgery Physician
Primary
109148
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/15/2014
Last updated
12/15/2022
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