| NPI | 1407275183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY J. SCHUMACHER Chief Financial Officer 763-784-7993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2018-01-15 |