| NPI | 1912033077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH L FUNG President 651-636-5149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 10696) |
| Enumeration Date | 2007-02-25 |
| Last Update Date | 2020-08-22 |