Roettger, Mark Allen

Roettger, Mark Allen is an individual health care provider with primary practice located at 12425 55Th Street N Suite B, Lake Elmo MN 55042-4450. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Roettger, Mark Allen can be contacted via phone (651) 439-0322.

Contact Information

Primary practice address
12425 55Th Street N Suite B Lake Elmo MN 55042-4450
Phone: (651) 439-0322
Fax: (651) 439-2201
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 9426 Minnesota

Profile Details

NPI number 1356325906
LBN Legal business name Roettger, Mark Allen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated May 11th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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