Prunty, Travis Andrew
Prunty, Travis Andrew is an individual health care provider with primary practice located at 730 Madison Ave , Mankato MN 56001-6100. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Prunty, Travis Andrew can be contacted via phone (507) 388-3023.Contact Information
Primary practice address
730 Madison Ave
Mankato MN 56001-6100
Phone: (507) 388-3023
Fax: (507) 388-3353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 12552 | Minnesota |
Profile Details
| NPI number | 1275685190 |
|---|---|
| LBN Legal business name | Prunty, Travis Andrew |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2007 |
| Last updated | Jan 18th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275685190 | NPPES |
| Minnesota | MEDICAID | 12552 |
Popular Providers
-
Neumann, Andrew
608 E Madison Ave , Mankato MN 56001-6112 -
Torbenson, Kevin J
608 E Madison Ave , Mankato MN 56001-6112 -
Stavish, Dawn Marie
309 Holly Ln , Mankato MN 56001-5422 -
Medrano, Bienvenido Zaragoza
309 Holly Ln , Mankato MN 56001-5422 -
Knudson, James Paul
730 Madison Ave , Mankato MN 56001 -
Starr, Garrett
120 N Augusta Ct Suite 108, Mankato MN 56001-8707 -
Burgess, Douglas Wilford
730 Madison Avenue , Mankato MN 56001 -
Connors, James Daniel
201 North Broad St Suite 204, Mankato MN 56001