| NPI | 1801941943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M COONEY CAO 952-883-7565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |