Individual
DR. JOHN CHARLES HITZEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11354 WILDWOOD CT NE, BLAINE, MN 55449-5901
(763) 783-0474
Mailing address
11354 WILDWOOD CT NE, BLAINE, MN 55449-5901
(763) 783-0474
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8102
MN
Other
Enumeration date
11/01/2009
Last updated
11/01/2009
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