| NPI | 1497929947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE CAROL RUNNING Dental Assistant 651-731-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9829) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |