| NPI | 1619141942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R GAASEDLEN Owner 763-588-8426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D8650) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2008-04-17 |