| NPI | 1912498148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARKO KAMEL Owner 651-436-7559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D12206) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2018-05-23 |