| NPI | 1215465372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY J AMUNDSON Office Manager 701-772-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ND 1781) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2022-07-21 |