NPI | 1144036393 |
---|---|
Entity Type | Organization |
Authorized Contact | SIMONE RENEE HOGAN Mdva Healthcare Operations Director 612-505-4110 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Enumeration Date | 2024-12-03 |
Last Update Date | 2024-12-03 |