| NPI | 1265554075 |
|---|---|
| Doing Business As | KID GRINS PEDIATRIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | AMEY L SEVERSON Owner 952-925-5334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MN D12014) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2016-09-13 |