| NPI | 1679620801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES CARL BLOCK Owner/President 952-935-8420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2015-12-14 |