| NPI | 1376615450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER M JORGENSON C.E.O. 320-235-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9800) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |