| NPI | 1962754606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE ALLEN BOHNSACK Dds/Owner 320-286-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D8315) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2012-10-24 |