| NPI | 1326398025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD J GRAY President 507-272-4912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MN D11595) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MN D8111) |
| 1223E0200X Dentist, Endodontics (Licence: MN D13634) | |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2016-08-09 |