| NPI | 1063525848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP J LINGLE President 763-389-1373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9019) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |