Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | S20 | MN |
N | 1223X0400X | Orthodontists | 5001916 | WI |
N | 204E00000X | Oral & Maxillofacial Surgeon | S20 | MN |
NPI | 1215077847 |
---|---|
Provider Name | Dr. John Volz |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2007 |
Last Update Date | 05/08/2020 |