| NPI | 1841463072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA FAYE DROST-SANDY Dentist/President Of Corporation 218-386-2889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MN D11132) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2008-04-09 |