| NPI | 1396833554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN PAUL WHOOLERY President 218-739-2217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D9505) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-05-29 |