Individual
MADELINE R GOETTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
701 25TH AVE S, SUITE 400, MINNEAPOLIS, MN 55454-1513
(612) 659-4900
Mailing address
2222 VINING DR, UNIT E, WOODBURY, MN 55125-7546
(414) 510-3226
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7056 - 15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
WI
Other
Enumeration date
04/19/2013
Last updated
11/10/2014
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