| NPI | 1265665350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN WORSING MERRY Owner 952-942-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9616) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12697) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |