Provider Demographics
NPI:1063510188
Name:DUERST, LOIS F (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:F
Last Name:DUERST
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 CURVE CREST BLVD W
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6069
Mailing Address - Country:US
Mailing Address - Phone:651-430-0036
Mailing Address - Fax:651-430-0191
Practice Address - Street 1:1395 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6069
Practice Address - Country:US
Practice Address - Phone:651-430-0036
Practice Address - Fax:651-430-0191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND10039122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist