Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ALEX PROVO
Active Sole ProprietorALEX PROVO is a Dentist healthcare provider located in ADA, Minnesota. NPI 1750762555 is currently active in the NPPES registry. Verify at CMS.
Dentist · ADA, MN
Registration Details
- NPI Number
- 1750762555
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 17, 2015 (10.978706416084 yrs)
- Last Updated
- Jun 17, 2015
- License
-
D13521 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
200 E MAIN STADA, MN, 565101354Browse MN providers · Browse ZIP 56510
- Phone
- 2187847119
- Primary Specialty
-
Dentist
122300000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.