Provider Demographics
NPI:1649616103
Name:DRONTLE, DANIEL PETER (PHARM D, R PH)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PETER
Last Name:DRONTLE
Suffix:
Gender:M
Credentials:PHARM D, R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1485 SAINT PAUL AVE
Mailing Address - Street 2:APT. 9
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2796
Mailing Address - Country:US
Mailing Address - Phone:651-414-0135
Mailing Address - Fax:
Practice Address - Street 1:300 CLYDESDALE TRL
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:MN
Practice Address - Zip Code:55340-4538
Practice Address - Country:US
Practice Address - Phone:763-852-0007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN121124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist