| NPI | 1912303777 |
|---|---|
| Doing Business As | SENIOR MOBILE DENTAL MINNESOTA LTD |
| Entity Type | Organization |
| Authorized Contact | PATRICIA MICHELLE VACHA Executive Director 763-545-7545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12696) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: CO 20071454175) |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2014-11-07 |