| NPI | 1033223581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PAUL SKADRON Owner 612-721-2424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10636) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-08-22 |