| NPI | 1467047720 |
|---|---|
| Doing Business As | MAPLE GROVE DENTAL |
| Entity Type | Organization |
| Authorized Contact | MATTHEW J OBOIKOVITZ President 715-581-2788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-03-08 |