| NPI | 1285825729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG VERNON DUREN Owner 952-435-4142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10619) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2007-08-08 |