| Kenmare Dental Clinic | |
|
318 1st Ave Ne Kenmare ND 58746-0638 | |
| (701) 385-4041 | |
| (701) 385-4986 |
| Full Name | Kenmare Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 318 1st Ave Ne, Kenmare, North Dakota |
| Authorized Official Name and Position | Tracy Lynn Thelen (OFFICE MANAGER) |
| Authorized Official Contact | 7013854041 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenmare Dental Clinic P.o. Box 638 Kenmare ND 58746-0638 Ph: (701) 385-4041 | Kenmare Dental Clinic 318 1st Ave Ne Kenmare ND 58746-0638 Ph: (701) 385-4041 |
| NPI Number | 1164677399 |
|---|---|
| Provider Enumeration Date | 12/02/2008 |
| Last Update Date | 12/02/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164677399 | NPI | - | NPPES |
| 41118 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1792 (North Dakota) | Primary |