| NPI | 1124230800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PATRICK DALE President 763-245-2072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10980) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2014-08-13 |