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 |