| NPI | 1720479462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S GESKO Senior VP/Dental Director 952-967-7577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10193) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2015-02-17 |