| NPI | 1780938688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIANA LUCAS Dentist 320-229-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D12500) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D12249) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2012-10-31 |