| NPI | 1013070291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG J BRANDENBURG Owner 612-721-6233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9418) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |