| NPI | 1174751531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM E GODMARE President 218-741-9251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9169) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |