| NPI | 1578893632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMI MCROBERTS Office Manager 218-739-2481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 1420707) |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2010-01-12 |