| NPI | 1609105816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG LLOYD BREMSETH Owner 651-388-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN 10623) |
| Enumeration Date | 2009-12-17 |
| Last Update Date | 2009-12-17 |