| NPI | 1881250520 |
|---|---|
| Doing Business As | GREENWAY DENTAL |
| Entity Type | Organization |
| Authorized Contact | SAM LACHANCE Owner 612-424-6850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2019-05-17 |