| NPI | 1104505015 | 
|---|---|
| Doing Business As | UNIVERSITY OF MINNESOTA SPECIAL HEALTHCARE NEEDS CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | ANGELA M ERICKSON Credentialing Coordinator 612-626-4232 | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental | 
| Enumeration Date | 2023-07-17 | 
| Last Update Date | 2023-07-17 |