| NPI | 1891240354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEIDI JO LUND Operations Leader 701-866-1894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 2265) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2021-03-31 |