Healthcare Provider Details

I. General information

NPI: 1356274807
Provider Name (Legal Business Name): GRACE SCHERESKY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 BURDICK EXPY W
MINOT ND
58701-5667
US

IV. Provider business mailing address

3888B 14TH ST NW
GARRISON ND
58540-2301
US

V. Phone/Fax

Practice location:
  • Phone: 701-852-8807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number844
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: