| NPI | 1770228983 |
|---|---|
| Doing Business As | BLUFFSIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | JEREMY SCOTT BERGER Sole Member 612-720-3154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-05-02 |