| NPI | 1932313194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN CHRISTINE BORAAS Corporation President 612-866-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN 9654) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |