PAYTON PENDERGAST, DT

Dental Therapist

Active Individual
NPI: 1265324388

Practice Address

309 HOLLY LN
Mankato, MN 56001

Phone: (507) 388-2120

Specialties

Specialty Code Primary License
Dental Therapist 125J00000X Yes DT189 (MN)

Frequently Asked Questions

NPI 1265324388 is the National Provider Identifier for PAYTON PENDERGAST, DT, a Dental Therapist provider located in Mankato, MN. This NPI was enumerated on July 15, 2025.
PAYTON PENDERGAST, DT practices at 309 HOLLY LN, Mankato, MN 56001.

Quick Facts

NPI
1265324388
Type
Individual
Enumerated
Jul 15, 2025
Last Updated
Oct 13, 2025

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