| NPI | 1659554517 |
|---|---|
| Doing Business As | WAYZATA DENTAL |
| Entity Type | Organization |
| Authorized Contact | JASON T MCDOWELL Owner 952-473-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |