Individual
DR. RICHARD BRIAN WITTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13055 RIVERDALE DR NW, SUITE 400, COON RAPIDS, MN 55448-8403
(612) 243-9357
(763) 323-7487
Mailing address
3880 ZIRCON LN N, PLYMOUTH, MN 55446-2837
(763) 478-8554
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
8787
MN
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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