| NPI | 1881091486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JAMES CARRELL Dentist 612-202-9749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN D12901) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-12-10 |