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General NPI Number Information
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NPI Number | 1174138507
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Entity Type | Organization
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Legal Business Name | SONTAK FAMILY CLINIC PLLC
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 4023 STATE ST STE 60
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City | BISMARCK
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State | ND
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Zip | 58503-0690
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Country | US
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Telephone | 701-390-2431
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Fax |
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Provider Business Mailing Address
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Address Line | 4023 STATE ST STE 60
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City | BISMARCK
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State | ND
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Zip | 58503-0690
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. SONIA TAKACS
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Credential | DNP/FNP-C
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Telephone | 701-751-1281
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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