| NPI | 1912050683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH CHRISTINE EGGERT President 651-482-8412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11799) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |