| NPI | 1235874090 | 
|---|---|
| Doing Business As | WEST SPRINGFIELD DENTAL ARTS | 
| Entity Type | Organization | 
| Authorized Contact | CHAD HENDRICKS Credentialing 612-859-0444  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice | 
| Enumeration Date | 2022-05-04 | 
| Last Update Date | 2022-05-04 |