| NPI | 1194826917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE ANN HORNER Administrative Assistant 763-257-0530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN 9698) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-05-22 |