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General NPI Number Information
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NPI Number | 1487084679
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Entity Type | Organization
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Legal Business Name | MESSER DENTAL PC
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Dates
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Enumeration Date | 11/25/2013
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Last Update Date | 11/25/2013
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Provider Practice Location Address
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Address Line | 2224 1ST AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-6286
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Country | US
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Telephone | 701-290-2082
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Fax |
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Provider Business Mailing Address
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Address Line | 2224 1ST AVE W
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City | WILLISTON
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State | ND
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Zip | 58801-6286
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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 | MEMBER
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Name | JEREMY MESSER
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Credential |
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Telephone | 701-290-2082
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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 |
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License Number State |
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