| NPI | 1295907202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK WILLIAM MARKSBERRY Owner 763-757-4170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11789) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |