| Oral Surgery Center Of Bismarck, Pc | |
|
3117 N 14th St Bismarck ND 58503-0664 | |
| (701) 221-2719 | |
| (701) 221-2819 |
| Full Name | Oral Surgery Center Of Bismarck, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 3117 N 14th St, Bismarck, North Dakota |
| Authorized Official Name and Position | Mansureh S Iravani (OWNER) |
| Authorized Official Contact | 7012212719 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oral Surgery Center Of Bismarck, Pc 3117 N 14th St Bismarck ND 58503-0664 Ph: (701) 221-2719 | Oral Surgery Center Of Bismarck, Pc 3117 N 14th St Bismarck ND 58503-0664 Ph: (701) 221-2719 |
| NPI Number | 1477723591 |
|---|---|
| Provider Enumeration Date | 03/04/2008 |
| Last Update Date | 04/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477723591 | NPI | - | NPPES |
| 41342 | Medicaid | ND | |
| 24538 | Other | ND | BCBS |
| 949124 | Other | ND | DENTAL SERVICE CORP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 1928 (North Dakota) | Primary |
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