| NPI | 1396343737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA KLEINJAN Office Manager 701-258-7220 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |