| Selle Family Dental, Pc | |
|
1560 Western Dr Dickinson ND 58601-3155 | |
| (701) 483-9801 | |
| (701) 483-9803 |
| Full Name | Selle Family Dental, Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1560 Western Dr, Dickinson, North Dakota |
| Authorized Official Name and Position | Shannon Selle (VICE PRESIDENT) |
| Authorized Official Contact | 7014839801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Selle Family Dental, Pc 1560 Western Dr Dickinson ND 58601-3155 Ph: (701) 483-9801 | Selle Family Dental, Pc 1560 Western Dr Dickinson ND 58601-3155 Ph: (701) 483-9801 |
| NPI Number | 1932361524 |
|---|---|
| Provider Enumeration Date | 06/26/2008 |
| Last Update Date | 05/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932361524 | NPI | - | NPPES |
| 41362 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 1914 (North Dakota) | Primary |
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