| NPI | 1932247921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE TONJUM Administrator 507-334-6433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D7800) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D9884) |
| 1223G0001X Dentist, General Practice (Licence: MN D10323) | |
| 1223G0001X Dentist, General Practice (Licence: MN D11586) | |
| 1223G0001X Dentist, General Practice (Licence: MN D11400) | |
| 1223G0001X Dentist, General Practice (Licence: MN D11631) | |
| 1223G0001X Dentist, General Practice (Licence: MN D8742) | |
| 261QD0000X Clinic/Center, Dental (Licence: MN D7800) | |
| 261QD0000X Clinic/Center, Dental (Licence: MN D13095) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-06 |