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Individual

DR. BRANDON D DEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, MSD

Contact information

Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6275
(612) 904-4234
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6275
(612) 904-4234

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
R386
MN
1223P0700X
Prosthodontics
Primary
D12597
MN

Other

Enumeration date
02/14/2008
Last updated
04/07/2011
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