| NPI | 1922184621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOEL KORENGOLD Business Manager 612-870-4646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9164) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2008-07-14 |