| NPI | 1821228347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN ELIZABETH JENNEN Dentist 651-699-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D11243) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2009-07-17 |