Healthcare Provider Details

I. General information

NPI: 1932631280
Provider Name (Legal Business Name): NESS FAMILY DENTISTRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 03/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 S BROADWAY SUITE 20
MINOT ND
58701-4667
US

IV. Provider business mailing address

1015 S BROADWAY SUITE 20
MINOT ND
58701-4667
US

V. Phone/Fax

Practice location:
  • Phone: 701-838-1123
  • Fax: 701-838-1261
Mailing address:
  • Phone: 701-838-1123
  • Fax: 701-838-1261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License NumberD2245
License Number StateND

VIII. Authorized Official

Name: DR. ALEXANDER NESS
Title or Position: OWNER
Credential: D.M.D.
Phone: 701-838-1123