Individual
ROGER ETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
701 PARK AVE, P7, MINNEAPOLIS, MN 55415-1623
(612) 873-2370
Mailing address
7001 PARK AVE, MINNEAPOLIS, MN 55423-3260
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08998
MN
Other
Enumeration date
05/16/2006
Last updated
07/08/2007
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