| NPI | 1629222849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MICHAEL DEETER Owner 701-425-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 2013) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2008-11-14 |