| 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 |