| NPI | 1013517093 |
|---|---|
| Doing Business As | THE DENTAL SPECIALIST ORTHODONTICS WOODBURY |
| Entity Type | Organization |
| Authorized Contact | SHANNON HESSE Credentialing Specialist 651-746-2815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |