| NPI | 1295145662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE MIN Partner 712-574-3307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 61151) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 56036) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2014-05-06 |