| 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 |