Healthcare Provider Details
I. General information
NPI: 1245272277
Provider Name (Legal Business Name): TRINITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2006
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2815 16TH ST SW STE 100
MINOT ND
58701-6916
US
IV. Provider business mailing address
PO BOX 5010
MINOT ND
58702-5010
US
V. Phone/Fax
- Phone: 701-857-2600
- Fax: 701-857-2610
- Phone: 701-857-2600
- Fax: 701-857-2610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS0112X |
| Taxonomy | Oral and Maxillofacial Surgery Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOHN
M
KUTCH
Title or Position: PRESIDENT & CEO
Credential:
Phone: 701-418-8000