| NPI | 1649867334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT BOWLBY Orthodontist/Owner 612-332-4344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2020-12-29 |