| NPI | 1649400797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY LYNN SANTJER Owner/President 701-776-5884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 122300000X Dentist |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2024-01-09 |