| NPI | 1770703688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR DAVID RAJEK President 952-432-0010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MN 8037) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |