| NPI | 1568804193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE FEIL Owner 701-222-8668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ND 2012) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |