NPI | 1629808308 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK WEIGAND Owner 701-339-8776 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice |
Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
Enumeration Date | 2024-08-06 |
Last Update Date | 2024-08-06 |