Healthcare Provider Details

I. General information

NPI: 1083784706
Provider Name (Legal Business Name): DAKOTA CLINIC, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

275 11TH ST S
WAHPETON ND
58075-4655
US

IV. Provider business mailing address

275 11TH ST S
WAHPETON ND
58075-4655
US

V. Phone/Fax

Practice location:
  • Phone: 701-642-2000
  • Fax: 701-671-4106
Mailing address:
  • Phone: 701-642-2000
  • Fax: 701-671-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateND
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateND
# 6
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateND
# 7
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateND
# 8
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateND
# 9
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateND

VIII. Authorized Official

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