| NPI | 1972616902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT E. RENSCH President 763-427-1363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2016-03-29 |