| NPI | 1285768812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R BOWLBY General Partner 952-926-1626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0008X Dentist Oral and Maxillofacial Radiology |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |