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Individual

DR. DUSTIN MATTHEW DITCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S, M.S

Contact information

Practice address
510 22ND AVE E STE 702, ALEXANDRIA, MN 56308
(320) 460-8400
Mailing address
510 22ND AVE E STE 702, ALEXANDRIA, MN 56308-4653
(320) 460-8400

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
13650
MN
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D13650
MN

Other

Enumeration date
06/20/2016
Last updated
08/14/2018
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