| NPI | 1184896938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A ANDERSON Orthodontist 507-665-3394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |