Individual
DR. MAX DISSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(218) 849-4891
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
67942
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2016
Last updated
08/27/2020
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