NPI | 1699901140 |
---|---|
Entity Type | Organization |
Authorized Contact | JULIE A CHAVEZ Owner 952-465-0105 |
Organization Subpart ? | No |
Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: MN D11399) |
Enumeration Date | 2009-06-10 |
Last Update Date | 2014-06-23 |