| NPI | 1508252578 |
|---|---|
| Doing Business As | ASPEN DENTAL |
| Entity Type | Organization |
| Authorized Contact | KIM VAN CAMP Provider Enrollment Specialist 315-454-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 13499) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |