| NPI | 1336378975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON MICHAEL SPYCHALA Owner 320-845-2032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN d12394) |
| Enumeration Date | 2009-07-03 |
| Last Update Date | 2009-07-03 |