Individual
DR. TEARA JERVON WUOLLET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1963 ROBERT ST S # 100, WEST ST PAUL, MN 55118-3942
(952) 237-2928
Mailing address
14395 HAYES RD, APPLE VALLEY, MN 55124-6739
(952) 237-2928
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D15000
MN
Other
Enumeration date
07/11/2023
Last updated
08/17/2023
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