| NPI | 1821493396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES GRAHAM Chief Manager 612-827-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D9958) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-10-27 |