| NPI | 1154568293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL MARGARET DULAC Owner 952-925-2176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10883) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2009-01-12 |