NPI | 1154575199 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDOLPH RICHARD PITZER Owner Pres 701-774-0259 |
Organization Subpart ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: ND 1628) |
Additional Taxonomies | 122300000X Dentist (Licence: ND 2010) |
Enumeration Date | 2008-11-04 |
Last Update Date | 2008-11-04 |