| NPI | 1689748295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREEMAN WAYNEWOOD Owner 651-647-9697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 8084) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2008-02-01 |