| NPI | 1245416403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE M SAICE Office Manager 651-699-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 7662) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-06-26 |