| NPI | 1518027754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS L BOE Director Dental Departmen 218-299-6819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-22 |