| NPI | 1184980112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM HOWARD HARRISON Owner 651-646-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D11121) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-04-04 |