| NPI | 1558776815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN A NIELSEN Office Manager 612-822-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN 8320) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |