| Park River Dental | |
|
418 Briggs Avenue Park River ND 58270-0662 | |
| (701) 284-6131 | |
| Not Available |
| Full Name | Park River Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 418 Briggs Avenue, Park River, North Dakota |
| Authorized Official Name and Position | Brian James Larson (OWNER/DENTIST PRESIDENT) |
| Authorized Official Contact | 7012846131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park River Dental Po Box 662 Park River ND 58270-0662 Ph: (701) 284-6131 | Park River Dental 418 Briggs Avenue Park River ND 58270-0662 Ph: (701) 284-6131 |
| NPI Number | 1174666119 |
|---|---|
| Provider Enumeration Date | 02/15/2007 |
| Last Update Date | 06/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174666119 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1805 (North Dakota) | Primary |
| 1223G0001X | Dentist - General Practice | 1355 (North Dakota) | Secondary |
Lifetime Dental Partners, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 321 Briggs Ave S, Suite 3, Park River, ND 58270 Phone: 701-284-7777 Fax: 701-284-6776 |