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NPI Code Detail

MEDICARE: DR. DUSTIN DUKART D.C.

MEDICARE:  DR. DUSTIN  DUKART  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor6075MN

General Provider Information

NPI Number : 1861886921
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN DUKART D.C.
Provider Business Mailing Address
First Line : 321 BROADWAY AVE STE 14
Second Line :
City : ST PAUL PARK
State : MN
Zip : 55071-1841
Country : US
Telephone Number : 612-314-9482
Fax Number :
Provider Business Practice Location Address
First Line : 321 BROADWAY AVE STE 14
Second Line :
City : ST PAUL PARK
State : MN
Zip : 55071-1841
Country : US
Telephone Number : 612-314-9482
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2015
Last Update Date : 11/13/2019

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Directions to “ DR. DUSTIN DUKART D.C.” Practice Location

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