NPI | 1710442413 |
---|---|
Doing Business As | GREAT RIVER ORTHODONTICS |
Doing Business As | SMILES IN MOTION |
Entity Type | Organization |
Authorized Contact | STEVEN KRISTO Owner 651-777-8182 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2019-02-06 |
Last Update Date | 2019-12-16 |