| NPI | 1619025798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W KUIPERS Owner 952-892-3282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 7434) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |