Healthcare Provider Details

I. General information

NPI: 1154524056
Provider Name (Legal Business Name): THOMAS D DRESSEL MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 04/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6545 FRANCE AVE SO. SUITE 301
EDINA MN
55435
US

IV. Provider business mailing address

7801 E. BUSH LAKE ROAD SUITE #320
BLOOMINGTON MN
55439
US

V. Phone/Fax

Practice location:
  • Phone: 952-929-1812
  • Fax: 952-929-1943
Mailing address:
  • Phone: 952-831-5773
  • Fax: 952-831-7224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number22143
License Number StateMN

VIII. Authorized Official

Name: THOMAS D. DRESSEL
Title or Position: MD/OWNER
Credential: MD
Phone: 952-929-1812