Healthcare Provider Details
I. General information
NPI: 1265636963
Provider Name (Legal Business Name): CHRISTINA TOVE DUNN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/14/2007
Last Update Date: 09/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3305 CENTRAL PARK VILLAGE DR STE 200
EAGAN MN
55121-7707
US
IV. Provider business mailing address
3305 CENTRAL PARK VILLAGE DR STE 200
EAGAN MN
55121-7707
US
V. Phone/Fax
- Phone: 651-406-8860
- Fax:
- Phone: 651-406-8860
- Fax: 651-688-7864
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 19611 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: