Individual
JODI MARIE BURTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
11256 86TH AVE N, MAPLE GROVE, MN 55369
(763) 493-9446
(763) 493-3045
Mailing address
11256 86TH AVE N, MAPLE GROVE, MN 55369
(763) 493-9446
(763) 493-3045
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D112384
MN
Other
Enumeration date
06/05/2007
Last updated
08/07/2007
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