| NPI | 1114208014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE HELD Dentist 507-377-5033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN d11601) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2011-09-06 |