NPI | 1104911056 |
---|---|
Doing Business As | BLUE WATER ORAL AND FACIAL SURGERY |
Entity Type | Organization |
Authorized Contact | KATHERINE ANNE LAFLEUR Practice Administrator 218-722-1854 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
Enumeration Date | 2006-10-04 |
Last Update Date | 2024-10-01 |