NPI | 1932206539 |
---|---|
Doing Business As | UPTOWN SMILE |
Entity Type | Organization |
Authorized Contact | PATRICK JAMES PROCHASKA President 612-822-1484 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2006-09-19 |
Last Update Date | 2020-08-22 |