Provider Demographics
NPI:1316099872
Name:ZAJICEK-DAGGETT, BARBARA L (DDS)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:L
Last Name:ZAJICEK-DAGGETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16057 673RD AVE
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:MN
Mailing Address - Zip Code:55350
Mailing Address - Country:US
Mailing Address - Phone:320-583-8389
Mailing Address - Fax:
Practice Address - Street 1:301 BECKER AVE SW
Practice Address - Street 2:
Practice Address - City:WILMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-5620
Practice Address - Country:US
Practice Address - Phone:320-214-2620
Practice Address - Fax:320-214-2630
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND92951223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN036871700Medicaid