| NPI | 1841521572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELVIN LEE HANSEN Owner 701-324-4180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ND 1605) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: ND 1797) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |