| NPI | 1588005169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORINE C SCHULTZ Hr Director 651-925-8427 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2024-06-27 |