Payton Lee Pendergast, DT Valid NPI

Individual provider · Dental Therapist · Mankato, MN

NPI

1265324388

Type

Individual (Type 1)

Primary specialty

Dental Therapist

Specialty group

Dental Providers

Taxonomy code

125J00000X

License number

DT189 (MN)

Sex

Female

Sole proprietor

No

Enumerated

2025-07-15

Last updated

2025-10-13