| NPI | 1083789507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS W WALDRON President 651-768-8180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MN D10981) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |