| NPI | 1710317326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID COLLIER Owner 320-253-8380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D11694) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |