| NPI | 1043642135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER J STANTON Dentist 651-488-5522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 8140) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 10691) |
| 122300000X Dentist (Licence: MN D12450) | |
| 122300000X Dentist (Licence: MN D13219) | |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-08-08 |