| NPI | 1598243990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH L CARLSON President/CEO 651-472-4713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12115) |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2023-03-07 |