| NPI | 1093954570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD WILLIAM NEILS President 701-293-0577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ND 1786) |
| Enumeration Date | 2009-02-06 |
| Last Update Date | 2009-02-06 |