Individual
ROGER FERDINAND LEUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
811 & ONE HALF MAIN STREET, HEBRON, ND 58638
(701) 878-4700
(701) 878-4700
Mailing address
PO BOX 98, HEBRON, ND 58638
(701) 878-4753
(701) 878-4753
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1402
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40023
—
ND
01
—
901402
BCBS
ND
Enumeration date
05/31/2007
Last updated
07/08/2007
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