| NPI | 1346273059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUG TALUS Vice President 952-938-7628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10137) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |