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Individual

ZACHARY MADER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
10945 ULYSSES ST NE STE 100, BLAINE, MN 55434-4186
(763) 784-1993
Mailing address
2565 FRANKLIN AVE APT 311, SAINT PAUL, MN 55114-3003
(052) 460-0894

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D15034
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/28/2023
Last updated
08/21/2024
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