Dominique Thaxton

NPI #1518799352 in Saint Paul, Minnesota

Provider Information

NPI Number: 1518799352
Entity Type: Individual
Name: Dominique Thaxton
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Contractor
Enumeration Date: Aug 19, 2024
Last Updated: Aug 19, 2024

Practice Location

Address: 540 FAIRVIEW AVE N
City: Saint Paul
State: Minnesota
ZIP Code: 55104-1753
Phone: (952) 688-7308

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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