| NPI | 1811314172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN A NELSON Dentist/Owner 651-322-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12088) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |