Individual provider · Type 1 NPI

Theodore James Dean, PA STUDENT

Student in an Organized Health Care Education/Training Program · Eden Prairie, MN

NPI number 1689567828 Active

Practice location

6612 Golden Ridge Dr
Eden Prairie, MN 55344-3201

Call (952) 807-7262 Map

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1689567828

Theodore James Dean, PA STUDENT's National Provider Identifier is 1689567828, issued on May 29, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Eden Prairie, MN. The record was last updated on May 29, 2025.