| NPI | 1740400985 |
|---|---|
| Other Name | LAKE SUPERIOR DENTAL HYGIENE LAKE SUPERIOR COMMUNITY DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CINDY A UPTON Dental Hygiene Clinic Coordinator 218-733-5939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-08-22 |