| NPI | 1972589182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARSH Business Office Supervisor 701-293-9829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2022-01-04 |