| NPI | 1902284573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BURCKHARD Owner/Orthodontist 701-838-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 2240) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |