| NPI | 1902116288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD WILLIAM BRUNTON President 651-351-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: WI 4482) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |