| NPI | 1518141548 |
|---|---|
| Doing Business As | SAND PRAIRIE DENTAL |
| Entity Type | Organization |
| Authorized Contact | ROGER J BROMAGHIM Owner 763-263-6350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9355) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |