| NPI | 1235305707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECCI ANN SWANSTROM Business Administrator 218-727-2349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11825) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2008-05-05 |