JORDAN DITTBERNER

WHITE BEAR LAKE, MN
NPI1174011597
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: WI  1001789)
Enumeration Date2018-05-01
Last Update Date2018-05-01
Business Address
JORDAN DITTBERNER DDS
4700 WHITE BEAR PKWY
WHITE BEAR LAKE, MN 55110-3336
Phone number: 651-762-7677
Mailing Address
JORDAN DITTBERNER DDS
7504 115TH ST N
WHITE BEAR LAKE, MN 55110-6182
Phone number: 651-308-1177