| NPI | 1548540321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL ANNE POPPEL Owner 507-373-5968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12409) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2020-04-13 |