| NPI | 1215184346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT WILLARD OLSON Dr. 507-625-7550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12094) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |