| NPI | 1730384280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | P. LOUIS MICHELICH President 763-551-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D7115) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2020-08-22 |