NPI | 1679765929 |
---|---|
Doing Business As | BAY CREEK DENTAL |
Entity Type | Organization |
Authorized Contact | PAUL D BOETTNER Owner 763-476-6774 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12160) |
Enumeration Date | 2007-08-10 |
Last Update Date | 2012-06-15 |