NPI | 1649597204 |
---|---|
Entity Type | Organization |
Authorized Contact | GARY L WILLIAMS President 763-559-4778 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9629) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 9675) |
1223G0001X Dentist, General Practice (Licence: MN 9629) | |
Enumeration Date | 2010-04-22 |
Last Update Date | 2010-04-22 |