| NPI | 1083814206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA A KENNARD Pediatric Dentist 952-475-3135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN 10780) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-25 |