| NPI | 1295010742 |
|---|---|
| Doing Business As | IDEAL IMAGE DENTISTRY & SPA |
| Entity Type | Organization |
| Authorized Contact | LEAH N BRADY Dentist 701-667-1933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ND 2070) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2011-10-20 |