| NPI | 1265114060 |
|---|---|
| Former Legal Business Name | RED RIVER DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | GARRET THORLAKSON Dentist, CEO 701-265-2931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |