| NPI | 1265535868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JOSEPH KOTTEMANN Owner 763-420-6834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MN 8583) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |