| NPI | 1487924833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY BUESGENS Office Manager 763-572-8040 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9081) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |