| NPI | 1427156249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID E DOMAAS President 763-218-5350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN 9409) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-11-29 |