| NPI | 1346365095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ERIC ANDERSEN Dentist Owner 218-732-3291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D10719) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-08-22 |