| Travis Prunty DDS PLLC | |
|
730 E Madison Ave Mankato MN 56001-6100 | |
| (507) 388-3023 | |
| (507) 388-3353 |
| Full Name | Travis Prunty DDS PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 730 E Madison Ave, Mankato, Minnesota |
| Authorized Official Name and Position | Travis Andrew Prunty (DDS) |
| Authorized Official Contact | 5073883023 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Travis Prunty DDS PLLC Po Box 894 Mankato MN 56002-0894 Ph: (507) 388-3023 | Travis Prunty DDS PLLC 730 E Madison Ave Mankato MN 56001-6100 Ph: (507) 388-3023 |
| NPI Number | 1235395476 |
|---|---|
| Provider Enumeration Date | 08/06/2008 |
| Last Update Date | 08/06/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235395476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D12552 (Minnesota) | Primary |
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