| NPI | 1831365006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED WILLIAM CARPENTER Orthodontist 651-771-7719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |