| NPI | 1356515969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON THOMAS ERISKSON President 507-238-2812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D10871) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |