| NPI | 1972952265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE D HAMMER Owner Dentist 218-728-5095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MN 13215) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |