| NPI | 1720199953 |
|---|---|
| Doing Business As | ELKO-NEW MARKET DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | STEVEN BLAINE PETERSEN Owner 952-469-2818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10525) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |