Individual
ROGER JOHN GORECTKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
110 MAPLE STREET, WOODRUFF, WI 54568-1130
(815) 356-6339
(715) 356-6355
Mailing address
PO BOX 1130, WOODRUFF, WI 54568-1130
(715) 356-6339
(715) 356-6355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3796015
WI
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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