Provider Demographics
NPI:1982065983
Name:DAGAN WELLNESS LLC
Entity Type:Organization
Organization Name:DAGAN WELLNESS LLC
Other - Org Name:DAGAN WELLNESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AYAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DNP
Authorized Official - Phone:507-271-6865
Mailing Address - Street 1:13971 W PRESERVE BLVD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-7733
Mailing Address - Country:US
Mailing Address - Phone:952-303-6085
Mailing Address - Fax:952-426-0785
Practice Address - Street 1:13971 W PRESERVE BLVD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-7733
Practice Address - Country:US
Practice Address - Phone:952-303-6085
Practice Address - Fax:952-426-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care