| NPI | 1174906911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH OSMUNDSON Office Manager 218-236-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D13580) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2016-05-12 |