| NPI | 1730308792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS E. SILVA President 952-233-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 8638530) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |