| NPI | 1447422175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LEE KOURY President 651-452-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10401) |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2008-04-02 |