| NPI | 1598129942 |
|---|---|
| Doing Business As | AMBER LEAF FAMILY DENTAL |
| Entity Type | Organization |
| Authorized Contact | FRANK RUSSOMANNO Owner 952-881-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN D11333) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |