Robert Alan Wightman

NPI #1952769697 in Cook, Minnesota

Provider Information

NPI Number: 1952769697
Entity Type: Individual
Name: Robert Alan Wightman
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 9, 2016
Last Updated: Jul 22, 2017

Practice Location

Address: 20 5TH ST SE
City: Cook
State: Minnesota
ZIP Code: 55723-9702
Phone: (218) 666-5958

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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