| NPI | 1114169224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRIN LEE KING Orthodontist 507-424-3632 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MN 11171) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-05-27 |