| NPI | 1861666786 |
|---|---|
| Doing Business As | PRAIRIE RIDGE ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | JEFFREY DONALD LOVELESS President 507-451-5993 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 11146) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |