| NPI | 1265753693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK GRABOWSKI Owner 320-251-1912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12072) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |