| NPI | 1235366808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUY ANH VU President 651-490-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D12683) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2019-06-11 |