| NPI | 1255491866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD P TREHARNE Dentist Owner 651-459-3039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 10404) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 8108) |
| 122300000X Dentist (Licence: MN 10522) | |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2008-01-02 |