| NPI | 1720621451 |
|---|---|
| Doing Business As | WASHINGTON SQUARE DENTAL |
| Entity Type | Organization |
| Authorized Contact | TRACY ANDERSON Director 651-353-6652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2019-10-25 |