| Custom Endodontics, PC | |
|
401 W Villard St Ste 104 Dickinson ND 58601-5283 | |
| (701) 255-2523 | |
| Not Available |
| Full Name | Custom Endodontics, PC |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 401 W Villard St Ste 104, Dickinson, North Dakota |
| Authorized Official Name and Position | Michaela Muniz (VP, PAYOR RELATIONS) |
| Authorized Official Contact | 4693243242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custom Endodontics, PC 401 W Villard St Ste 104 Dickinson ND 58601-5283 Ph: (701) 255-2523 | Custom Endodontics, PC 401 W Villard St Ste 104 Dickinson ND 58601-5283 Ph: (701) 255-2523 |
| NPI Number | 1508760307 |
|---|---|
| Provider Enumeration Date | 10/05/2026 |
| Last Update Date | 10/05/2026 |
| Certification Date | 10/05/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508760307 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Primary |
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