| NPI | 1376676445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS RICHARD SWENSON President 763-427-0285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D10339) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |