| NPI | 1922278753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP FOREST FABEL Owner 763-537-1292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN 7299) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-07 |