| NPI | 1134250236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J KELLER President 763-421-4550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10034) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-11-11 |