| NPI | 1053453688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GUY GRUCHALLA Co Owner, Dentist 701-235-1261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1957) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |