| NPI | 1427280163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY C. TANG President 612-240-5067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: WA DE60083251) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |