NPI | 1891100772 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA JILL GRABOUSKI Dentist 712-253-5703 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D13437) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2014-06-30 |