Individual
DR. MARISSA ANN GOPLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1317 GROVE AVE, MONTEVIDEO, MN 56265-1708
(320) 269-6416
Mailing address
1317 GROVE AVE, MONTEVIDEO, MN 56265-1708
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13548
MN
1223G0001X
General Practice Dentistry
D13548
MN
Other
Enumeration date
06/10/2015
Last updated
11/27/2018
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