| NPI | 1356749659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONAVENTURE NWOKOCHA CEO 763-710-9937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12960) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |