| NPI | 1902812126 |
|---|---|
| Other Name | WAYZATA ORTHODONTICS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL W. GLEYSTEEN Orthodontist 952-473-7037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN 8118) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2008-09-16 |