| Prairie Rose Family Dentists | |
|
121 E Front Ave Bismarck ND 58504-5589 | |
| (701) 223-1194 | |
| (701) 250-9614 |
| Full Name | Prairie Rose Family Dentists |
|---|---|
| Speciality | Dentist |
| Location | 121 E Front Ave, Bismarck, North Dakota |
| Authorized Official Name and Position | Bradley E King (PRESIDENT) |
| Authorized Official Contact | 7012231194 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prairie Rose Family Dentists 121 E Front Ave Bismarck ND 58504-5589 Ph: (701) 223-1194 | Prairie Rose Family Dentists 121 E Front Ave Bismarck ND 58504-5589 Ph: (701) 223-1194 |
| NPI Number | 1144391632 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144391632 | NPI | - | NPPES |
| 41286 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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