| NPI | 1326214164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM M CHART President 218-727-1448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 8120) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN 8124) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |