| NPI | 1285726158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA SCHULZ SCHULZ PETERSON Owner 952-890-2791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 11806) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 7600) |
| 122300000X Dentist (Licence: MN 11137) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2010-08-26 |