Individual
DR. BRUCE ROBERT WITTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
512 66TH AVE N, BROOKLYN CENTER, MN 55430-1643
(763) 560-3334
Mailing address
PO BOX 23029, RICHFIELD, MN 55423-0029
(612) 861-9123
(612) 861-9155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9625
MN
Other
Enumeration date
03/05/2006
Last updated
03/25/2015
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