| NPI | 1699190488 |
|---|---|
| Former Legal Business Name | BUFFALO DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | COREY J BRENNER Owner 612-819-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D11525) |
| Enumeration Date | 2014-03-03 |
| Last Update Date | 2014-03-03 |