Individual
DR. LORI LEE WITTEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
109 EAST 5TH ST, BOTTINEAU, ND 58318
(701) 228-3153
Mailing address
109 EAST 5TH ST, BOTTINEAU, ND 58318
(701) 228-3153
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1679
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40847
—
ND
01
—
901679
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/28/2006
Last updated
03/07/2023
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