NPI | 1609095140 |
---|---|
Entity Type | Organization |
Authorized Contact | JANET ANN NIELSEN Office Manager 763-476-6774 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 8320) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2020-08-22 |