| NPI | 1508238528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE CAROLINE KOTTAS Dentist 651-224-1192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D11602) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |