| NPI | 1568903243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SCOTT JOHNSON President 701-746-1481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 2176) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |