Roszkowski, Mark T

Roszkowski, Mark T is an individual health care provider with primary practice located at 625 E Nicollet Blvd Ste 205, Burnsville MN 55337-6734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Roszkowski, Mark T can be contacted via phone (952) 435-0310.

Contact Information

Primary practice address
625 E Nicollet Blvd Ste 205 Burnsville MN 55337-6734
Phone: (952) 435-0310
Fax: (952) 435-0311
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X D10761 Minnesota

Profile Details

NPI number 1699750802
LBN Legal business name Roszkowski, Mark T
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Jul 9th, 2010 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1699750802 NPPES
Minnesota Other 317R7RO BCBS
Minnesota MEDICAID 227315200 BCBS

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