NPI | 1528226156 |
---|---|
Entity Type | Organization |
Authorized Contact | KEITH ROBERT ERICKSON President 952-431-1111 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D9558) |
Enumeration Date | 2008-05-30 |
Last Update Date | 2008-05-30 |