| Great Northern Dental Care | |
|
667 Demers Ave Ste 1002 Grand Forks ND 58201-4500 | |
| (701) 772-8488 | |
| Not Available |
| Full Name | Great Northern Dental Care |
|---|---|
| Speciality | Clinic/center |
| Location | 667 Demers Ave Ste 1002, Grand Forks, North Dakota |
| Authorized Official Name and Position | John Clayburgh (DOCTOR) |
| Authorized Official Contact | 7017728488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Northern Dental Care 667 Demers Ave, Ste 1002 Grand Forks ND 58201 Ph: (701) 772-8488 | Great Northern Dental Care 667 Demers Ave Ste 1002 Grand Forks ND 58201-4500 Ph: (701) 772-8488 |
| NPI Number | 1356715841 |
|---|---|
| Provider Enumeration Date | 11/20/2015 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356715841 | NPI | - | NPPES |
| 1456616 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1688 (North Dakota) | Primary |
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