Healthcare Provider Details

I. General information

NPI: 1750216768
Provider Name (Legal Business Name): CHAZ J BAUER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

923 1ST ST S
CARRINGTON ND
58421-2004
US

IV. Provider business mailing address

610 72ND AVE NE
CARRINGTON ND
58421-8746
US

V. Phone/Fax

Practice location:
  • Phone: 701-652-2801
  • Fax:
Mailing address:
  • Phone: 701-650-0543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHAZ JAMES BAUER
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 701-650-0543