| NPI | 1568857100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JENSEN Denturist/Owner 1406-314-0273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: MT 7928) |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2015-03-31 |