NPI Provider: 1861497430
Contact Name: Hildahl A Mark
Position: owner
Phone: (701) 852-5595
Souris Valley Dental Group Information:
Souris Valley Dental Group organization have npi 1861497430, taxonomy code is 1223G0001X with license number is 1573 in . This Business address located in 601 18th Ave SE, Minot, ND 58701 North Dakota.
Practice Location
Address: 601 18th Ave SE, Minot, ND 58701
Phone: (701) 852-5595
Business Location
Address: 601 18th Ave SE, Minot, ND 58701
Phone: (701) 852-5595
Fax: (701) 852-2669
Taxonomy
Taxonomy Code: 1223G0001X
License Number: 1573
License Number of State: ND
Primary Taxonomy Switch: Y
Enumeration Date: 6/20/2005
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