| NPI | 1245321389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE H WELLNER President 218-751-4460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN 7899) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MN 10693) |
| 1223G0001X Dentist General Practice (Licence: MN D10878) | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |