| NPI | 1508374497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN C JACQUOT President/Dentist 701-523-5651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 2291) |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2018-01-14 |