| NPI | 1063644888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN ARTHUR PARKER President 952-345-0290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9503) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2023-10-02 |