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General NPI Number Information
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NPI Number | 1366052706
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Entity Type | Individual
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Provider Name | ANGELA DAHLGREN
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Gender | Female
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Dates
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Enumeration Date | 07/31/2020
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Last Update Date | 07/31/2020
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Provider Practice Location Address
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Address Line | 112A MAIN ST S
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City | PIERZ
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State | MN
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Zip | 56364-4400
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Country | US
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Telephone | 320-468-2072
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 166TH ST
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City | HADLEY
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State | MN
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Zip | 56151-2041
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 124842
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License Number State | MN
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