| NPI | 1306207113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL M PERPICH Dentist/Owner 218-546-5809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MN 9410) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |