| NPI | 1336158575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA IRENE KELLY Dentist 507-280-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11640) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2020-08-22 |