| NPI | 1861546111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SORENSON President 612-823-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D7605) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |