| NPI | 1285179945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL LLOYD WADE Oral Surgeon/President 651-578-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D9734) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-04-12 |