| NPI | 1942361324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESE RYDLUND Cda, Rda 651-462-7017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D10152) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |