| NPI | 1952399685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LUTHER BODIN President 952-224-9771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2009-10-28 |