Provider Demographics
NPI:1477566818
Name:DALSETH, STEPHEN E (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:E
Last Name:DALSETH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14505 GLAZIER AVE
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7550
Mailing Address - Country:US
Mailing Address - Phone:952-432-1101
Mailing Address - Fax:952-432-9798
Practice Address - Street 1:14505 GLAZIER AVE
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7550
Practice Address - Country:US
Practice Address - Phone:952-432-1101
Practice Address - Fax:952-432-9798
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN71851223G0001X
MN115211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice