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 |