NPI | 1609250620 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN MARTIN WEST President 701-293-5300 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: ND 1969) |
Enumeration Date | 2015-07-20 |
Last Update Date | 2015-07-20 |