| NPI | 1912246315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN L ANDERSON Dentist 218-631-4431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health |
| 124Q00000X Dental Hygienist | |
| 125J00000X Dental Therapist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |