Individual
DR. MARCUS VAN WITZENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
Mailing address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7942
OR
Other
Enumeration date
08/03/2006
Last updated
07/17/2007
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