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Individual
MARVIN VALLEJO
Active
Individual
MARVIN VALLEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
D13719
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
29838
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
68180
MN
Other
Enumeration date
04/11/2016
Last updated
03/30/2023
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