Healthcare Provider Details

I. General information

NPI: 1114977956
Provider Name (Legal Business Name): DMS IMAGING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 07/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 UNIVERSITY DR N
FARGO ND
58102-1816
US

IV. Provider business mailing address

2101 UNIVERSITY DR N
FARGO ND
58102-1816
US

V. Phone/Fax

Practice location:
  • Phone: 701-237-9073
  • Fax: 701-297-3077
Mailing address:
  • Phone: 701-237-9073
  • Fax: 701-297-3077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACIE HEIDEN
Title or Position: CFO
Credential:
Phone: 701-297-3097