| Ideal Image Dentistry & Spa | |
|
1008 E Main St Mandan ND 58554-3762 | |
| (701) 667-1933 | |
| Not Available |
| Full Name | Ideal Image Dentistry & Spa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1008 E Main St, Mandan, North Dakota |
| Authorized Official Name and Position | Fredrick A Landgrebe (OWNER/DENTIST) |
| Authorized Official Contact | 7016671933 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ideal Image Dentistry & Spa 1008 E Main St Mandan ND 58554-3762 Ph: (701) 667-1933 | Ideal Image Dentistry & Spa 1008 E Main St Mandan ND 58554-3762 Ph: (701) 667-1933 |
| NPI Number | 1891090668 |
|---|---|
| Provider Enumeration Date | 01/25/2011 |
| Last Update Date | 01/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891090668 | NPI | - | NPPES |
| 41545 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1593 (North Dakota) | Primary |
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