| NPI | 1083131643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN MATTHEW SARLES Doctor 952-447-1080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D13230) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2022-07-21 |