| NPI | 1760583231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN B MONTGOMERY Owner 651-765-1945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 8584) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: UT 1442499921) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: AZ D3327) | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2008-06-25 |