| NPI | 1437882354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW L ROHLF Owner 651-462-5150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-07-07 |
| Last Update Date | 2022-07-18 |