Provider Demographics
NPI:1477848356
Name:DYNDA, STEVEN
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:DYNDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7200 VALLEY CREEK PLZ
Mailing Address - Street 2:TARGET PHARMACY STORE NUMBER T-0694
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2265
Mailing Address - Country:US
Mailing Address - Phone:651-735-9517
Mailing Address - Fax:
Practice Address - Street 1:7200 VALLEY CREEK PLZ
Practice Address - Street 2:TARGET PHARMACY STORE NUMBER T-0694
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2265
Practice Address - Country:US
Practice Address - Phone:651-735-9517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-18
Last Update Date:2011-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112559183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist