Kenmare Dental Clinic | |
318 1st Ave Ne Kenmare ND 58746-0638 | |
(701) 385-4041 | |
(701) 385-4986 |
Full Name | Kenmare Dental Clinic |
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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 |
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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 |
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Provider Enumeration Date | 12/02/2008 |
Last Update Date | 12/02/2008 |
Identifier | Type | State | Issuer |
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1164677399 | NPI | - | NPPES |
41118 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 1792 (North Dakota) | Primary |