NPI | 1609485432 |
---|---|
Former Legal Business Name | AMETHYST DENTAL CARE |
Entity Type | Organization |
Authorized Contact | JOHN C. BOEKER Managing Partner 507-288-9288 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2020-07-28 |
Last Update Date | 2020-07-28 |