| NPI | 1912060351 |
|---|---|
| Doing Business As | BLOSSOM PARK DENTAL CARE |
| Entity Type | Organization |
| Authorized Contact | AMY M KROEGER Insurance Cood 218-540-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |