| NPI | 1780851014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRSTEN A. ANDREWS Owner 701-662-4961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 2001) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2015-08-11 |