NPI | 1528421278 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS ELLIS HOOVER Periodontist 952-920-9209 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MN D11710) |
Enumeration Date | 2016-03-31 |
Last Update Date | 2016-03-31 |