Individual
PAUL ANTHONY ROGGOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
604 SECOND STREET, JACKSON, MN 56143
(507) 847-3910
(507) 847-2868
Mailing address
604 SECOND STREET, JACKSON, MN 56143
(507) 847-3910
(507) 847-2868
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9644
MN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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