| NPI | 1598763120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH MARIE JAROSZEWSKI Finance Coordinator 701-478-4404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2022-07-21 |