| NPI | 1588899199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER EISENHUTH Physician / Owner 952-469-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D10874) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |