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General NPI Number Information
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NPI Number | 1336129113
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Entity Type | Organization
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Legal Business Name | DICKINSON DENTAL CENTER, P.C.
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2 1ST ST W #215
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City | DICKINSON
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State | ND
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Zip | 58601-5106
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Country | US
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Telephone | 701-483-6999
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Fax | 701-483-6998
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Provider Business Mailing Address
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Address Line | 2 1ST ST W #215
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City | DICKINSON
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State | ND
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Zip | 58601-5106
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Country | US
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Telephone | 701-483-6999
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Fax | 701-483-6998
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SHANNON DEAN GALSTER
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Credential | D.D.S.
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Telephone | 701-483-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1885
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License Number State | ND
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