| NPI | 1437162203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT M ANZELC Dentist/President 218-263-8929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 8045) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |