| NPI | 1740359546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYIA BUCHER Practice Administrator 507-451-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MN 07829) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |