| NPI | 1366772758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES C. ANDREA President 651-482-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D10099) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2010-01-06 |