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NPI Code Detail

MEDICARE: BROCK ALLEN OUKROP DDS

MEDICARE:   BROCK ALLEN OUKROP  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2006ND

General Provider Information

NPI Number : 1669674362
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROCK ALLEN OUKROP DDS
Provider Business Mailing Address
First Line : 4204 BOULDER RIDGE RD SUITE 140
Second Line :
City : BISMARCK
State : ND
Zip : 58503
Country : US
Telephone Number : 701-258-7900
Fax Number : 701-250-0557
Provider Business Practice Location Address
First Line : 4204 BOULDER RIDGE RD SUITE 140
Second Line :
City : BISMARCK
State : ND
Zip : 58503
Country : US
Telephone Number : 701-258-7900
Fax Number : 701-250-0557
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2007
Last Update Date : 12/05/2018

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Directions to “ BROCK ALLEN OUKROP DDS” Practice Location

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