| NPI | 1013326768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY CORNFORTH Orthodontist 701-232-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 1504C) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2014-08-07 |