| NPI | 1265595276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN G SWANSON Dds Owner 7635-553-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D11435) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 9384) |
| 122300000X Dentist (Licence: MN 9385) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |