| NPI | 1215299508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS CARRRERAS Owner/ Dentist 320-257-3380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D10920) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D12166) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2012-06-12 |