| NPI | 1144490723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT E. THIELMAN Owner/General Dentist 952-423-4414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D8510) |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2008-03-10 |