| NPI | 1134593106 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R ANDERSON Dentist 218-365-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9236) |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-13 |