| NPI | 1932361524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SELLE Vice President 701-483-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: ND 1914) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2009-05-11 |