| NPI | 1346393485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK JOSEPH ENNEN President 763-427-4912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN 7668) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2020-08-22 |