| NPI | 1528059979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN S KANYUSIK Owner Partner President 507-388-2989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2020-08-22 |