Healthcare Provider Details

I. General information

NPI: 1740359884
Provider Name (Legal Business Name): DAKOTA CLINIC, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 3RD ST SE
JAMESTOWN ND
58401-4247
US

IV. Provider business mailing address

401 3RD ST SE
JAMESTOWN ND
58401-4247
US

V. Phone/Fax

Practice location:
  • Phone: 701-253-5300
  • Fax: 701-253-5402
Mailing address:
  • Phone: 701-253-5300
  • Fax: 701-253-5402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateND
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateND
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateND

VIII. Authorized Official

Name: LARRY G SOLBERG
Title or Position: ADMINISTRATOR-AUTHORIZED OFFICIAL
Credential:
Phone: 701-364-3405