Individual
BENJAMIN R BUNTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1106 W RIVER RD, DETROIT LAKES, MN 56501-2723
(218) 846-1900
Mailing address
1106 W RIVER RD, DETROIT LAKES, MN 56501-2723
(218) 846-1900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13140
MN
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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