| NPI | 1255880944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD SNELL Owner 651-209-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10893) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 7161) |
| 1223G0001X Dentist, General Practice (Licence: MN 12412) | |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |