| NPI | 1003093485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R BOWLBY Doctor 952-435-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D12240) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2008-01-28 |