| NPI | 1497936389 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM JOHNSON Owner 612-823-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9512) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |