| NPI | 1265595995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT L HOLMAN President 701-232-1148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ND 1587) |
| Enumeration Date | 2006-12-17 |
| Last Update Date | 2020-08-22 |