Healthcare Provider Details

I. General information

NPI: 1407765456
Provider Name (Legal Business Name): PRO DOG SECURITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 GATEWAY DR STE B
GRAND FORKS ND
58203-2425
US

IV. Provider business mailing address

216 GATEWAY DR STE B
GRAND FORKS ND
58203-2425
US

V. Phone/Fax

Practice location:
  • Phone: 701-330-1427
  • Fax:
Mailing address:
  • Phone: 701-330-1427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: SCOTT WILLIAMS
Title or Position: GENERAL MANAGER
Credential:
Phone: 701-330-1427