| NPI | 1952418311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID THEOPHIL KUBES Owner 651-644-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN 8622) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2008-07-16 |