Individual
MARVIN VALLEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
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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