| NPI | 1265589642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W KUIPERS Owner 952-884-9161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 7434) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2009-11-09 |