| NPI | 1326649575 |
|---|---|
| Doing Business As | SRA DDS |
| Entity Type | Organization |
| Authorized Contact | SCOTT ROBERT ANDERSON Owner 218-365-3194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |