| NPI | 1649850892 |
|---|---|
| Doing Business As | DENTAL IMPLANT & RECONSTRUCTIVE CENTER |
| Entity Type | Organization |
| Authorized Contact | ROXANNA JEAN ESGUERRA President 218-722-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2021-04-12 |