Individual
DR. MARK T ROSZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
625 E NICOLLET BLVD, STE 205, BURNSVILLE, MN 55337-6734
(952) 435-0310
(952) 435-0311
Mailing address
625 E NICOLLET BLVD, STE 205, BURNSVILLE, MN 55337-6734
(952) 435-0310
(952) 435-0311
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D10761
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227315200
—
MN
01
—
317R7RO
BCBS
MN
Enumeration date
12/09/2005
Last updated
07/09/2010
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