| NPI | 1265654016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD MARK PETERSON President 701-232-3379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1578) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |