Individual
DR. MARK ALLEN ROETTGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12425 55TH STREET N, SUITE B, LAKE ELMO, MN 55042-4450
(651) 439-0322
(651) 439-2201
Mailing address
12425 55TH STREET N, SUITE B, LAKE ELMO, MN 55042-4450
(651) 439-0322
(651) 439-2201
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9426
MN
Other
Enumeration date
12/06/2005
Last updated
05/11/2011
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