| NPI | 1760509954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BARRY WOLF President 763-571-4837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10364) |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2020-08-22 |