Dakota Clinic, Ltd. - West Fargo | |
1401 13th Ave E West Fargo ND 58078-3468 | |
(701) 364-5751 | |
(701) 364-5750 |
Full Name | Dakota Clinic, Ltd. - West Fargo |
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Speciality | Family Medicine |
Location | 1401 13th Ave E, West Fargo, North Dakota |
Authorized Official Name and Position | Larry G Solberg (ADMINISTRATOR-AUTHORIZED OFFICIAL) |
Authorized Official Contact | 7013643405 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dakota Clinic, Ltd. - West Fargo Po Box 6001 Fargo ND 58108-6001 Ph: (701) 364-3300 | Dakota Clinic, Ltd. - West Fargo 1401 13th Ave E West Fargo ND 58078-3468 Ph: (701) 364-5751 |
NPI Number | 1093767154 |
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Provider Enumeration Date | 05/17/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093767154 | NPI | - | NPPES |
10046 | Medicaid | ND |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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