NPI | 1285974048 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEY WANGLER Dentist 701-255-0469 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: ND 2153) |
Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: ND 2154) |
Enumeration Date | 2013-02-15 |
Last Update Date | 2015-12-18 |