Individual
DR. EUGENE JOHN FORTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 4TH ST SW STE 300, MASON CITY, IA 50401-2856
(641) 424-0301
(641) 424-0301
Mailing address
2533 HAWK HILL LN. SW, ROCHESTER, MN 55902
(507) 288-1073
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
07746
MN
Other
Enumeration date
11/21/2006
Last updated
03/17/2018
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