| NPI | 1669972063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WAYNE SLETTEN Owner 651-439-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D11561) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |