| NPI | 1932399557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER E AUSTIN President/Owner 763-757-3120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN 07057) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2007-07-30 |