Lidgerwood Dental Office

Organization Active NPI Dental Clinic/Center · Lidgerwood, ND

NPI 1285043802 · NPPES record last updated Aug 7, 2014

Key facts

NPI
1285043802
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
License
1488 (ND)
Legal business name
LIDGERWOOD DENTAL OFFICE
Practice address
19 Wiley Ave S
Lidgerwood, ND 58053-4001
Phone
(701) 538-4583
Fax
(701) 538-4560
NPI assigned
Aug 7, 2014
Organization subpart
No

Authorized official

Name
Dr. James D Marotzke, DDS NPI 1376692756
Title
Owner
Phone
(701) 538-4583

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1488 ND Yes

Addresses

Primary practice location

19 Wiley Ave S
Lidgerwood, ND 58053-4001

Mailing address

19 Wiley Ave S
Lidgerwood, ND 58053-0431
Phone (701) 538-4583

Other providers in Lidgerwood, ND

All providers in Lidgerwood, ND · Dental Clinic/Center in North Dakota

Sources for this page

Verify at the official NPI Registry.