| NPI | 1003237512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A FREDRIKSON President 701-280-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1504) |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2014-01-06 |