| NPI | 1083789929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW F SPENCER Dentist Owner 952-922-8111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D10569) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN 10569) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-07-08 |