| NPI | 1497784342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SANFORD COOPER President 507-452-9453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9899) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D8406) |
| 1223G0001X Dentist, General Practice (Licence: MN D11568) | |
| 1223G0001X Dentist, General Practice (Licence: MN D10482) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |