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General NPI Number Information
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NPI Number | 1134211709
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Entity Type | Individual
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Provider Name | DENNIS E JANECKE DDS
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Gender | Male
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 212 S 4TH ST STE 200
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City | GRAND FORKS
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State | ND
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Zip | 58201-4781
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Country | US
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Telephone | 406-498-7191
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Fax | 406-723-3059
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Provider Business Mailing Address
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Address Line | 529 BRANDON BLVD
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City | EAST GRAND FORKS
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State | MN
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Zip | 56721-4801
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Country | US
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Telephone | 406-498-7191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2208
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2489
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License Number State | ND
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