Individual
MATTHEW J GOERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-5110
Mailing address
515 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0357
(612) 625-5110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019028769
IL
122300000X
Dentist
10555
CO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
R595
MN
Other
Enumeration date
08/21/2011
Last updated
07/02/2014
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