| NPI | 1033351457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORRIE K HODD Dentist 612-332-1255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 10117) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D7958) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |