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General NPI Number Information
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NPI Number | 1366423618
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Entity Type | Organization
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Legal Business Name | PRAIRIE IMAGING, PC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 112 3RD ST W
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City | DICKINSON
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State | ND
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Zip | 58601-5136
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Country | US
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Telephone | 701-486-4546
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Fax | 701-483-4545
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Provider Business Mailing Address
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Address Line | 112 3RD ST W
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City | DICKINSON
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State | ND
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Zip | 58601-5136
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Country | US
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Telephone | 701-486-4546
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Fax | 701-483-4545
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. GARRY K DUNN
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Credential | M.D.
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Telephone | 701-483-4546
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 9874
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License Number State | ND
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