| NPI | 1033875752 |
|---|---|
| Doing Business As | COSMETIC, FAMILY & SPORTS DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHASE SEUBERT CEO/Dentist 952-922-9119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-11-17 |
| Last Update Date | 2021-11-17 |