| NPI | 1184796740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK FREDRICK YSETH Chief Financial Officer 763-421-3330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9283) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2020-08-22 |