Goose River Dental Assoc., PC

Organization Active NPI General Practice Dentistry · Mayville, ND

NPI 1164522306 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1164522306
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
GOOSE RIVER DENTAL ASSOC., PC
Practice address
37 1/2 Main St E
Mayville, ND 58257
Phone
(701) 788-4064
Fax
(701) 788-9090
NPI assigned
Sep 25, 2006
Organization subpart
No

Authorized official

Name
Dr. Robert C Lauf Jr., DDS
Title
Owner
Phone
(701) 788-4064

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

37 Main St E
Mayville, ND 58257
Phone (701) 788-4064

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

37 1/2 Main St E
Mayville, ND 58257

Mailing address

37 1/2 Main St E
Mayville, ND 58257
Phone (701) 788-4064

Other identifiers

IdentifierTypeStateIssuer
41080MedicaidND

Other providers in Mayville, ND

All providers in Mayville, ND · General Practice Dentistry in North Dakota

Sources for this page

Verify at the official NPI Registry.