| NPI | 1134249774 |
|---|---|
| Doing Business As | FACULTY PRACTICE CLINIC |
| Entity Type | Organization |
| Authorized Contact | GARY CARL ANDERSON Dean, Uof Mn School Of Dentistry 612-626-6529 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2016-12-21 |