National Provider Identifier Database

WANDA J DALLY, MT – NPI #1740497775
Medical Technologist


Contact Information

WANDA J DALLY, MT
111 WASHINGTON AVE NW
WAGNER, SD57380
Phone: 605-384-3621
Fax: 605-384-3293
Website:
Specialty Taxonomy Code
* Medical Technologist 246QM0706X

* Indicates primary specialty

NPI Profile & details for WANDA J DALLY

NPI Number 1740497775
Credentials MT
Entity Individual
Enumeration date 05/17/2007
Last updated 07/09/2007 - About 19 years ago
Sole proprietor1 No
Identifiers
  • SD License #: 185598
  • SD Medicaid: 5540030
  • SD Medicaid: 5540100
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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