| NPI | 1700934882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER W KUIPERS Owner 651-388-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 7434) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |