NPI | 1144599135 |
---|---|
Entity Type | Organization |
Authorized Contact | TORI CONRAD President 612-834-1664 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D12562) |
Enumeration Date | 2011-12-20 |
Last Update Date | 2011-12-20 |