| NPI | 1528931532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MATTSON Controller 701-228-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 126800000X Dental Assistant |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 124Q00000X Dental Hygienist | |
| Enumeration Date | 2025-09-25 |
| Last Update Date | 2025-09-25 |