| NPI | 1043471337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES W SIMS Dentist / Owner 612-825-7835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D9005) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2008-06-19 |