Individual
JOHN CARLTON WITTENSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14990 GLAZIER AVE STE 100, APPLE VALLEY, MN 55124-7819
(612) 861-9123
(612) 861-9155
Mailing address
14990 GLAZIER AVE STE 100, APPLE VALLEY, MN 55124-7819
(952) 431-5114
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10082
MN
Other
Enumeration date
03/14/2006
Last updated
04/12/2023
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