| NPI | 1740343953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY L WILLIAMS President 763-559-4778 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9629) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 9675) |
| 1223G0001X Dentist, General Practice (Licence: MN D9675) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2008-07-10 |