| NPI | 1881864049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM KIM LARSON Dentist 218-631-4525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN d12083) |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-04 |