1033422613 NPI number — NORTH DAKOTA STATE COLLEGE OF SCIENCE

Table of content: (NPI 1033422613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033422613 NPI number — NORTH DAKOTA STATE COLLEGE OF SCIENCE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTH DAKOTA STATE COLLEGE OF SCIENCE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033422613
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ALLIED DENTAL EDUCATION DEPARTMENT
Provider Second Line Business Mailing Address:
800 N 6TH ST
Provider Business Mailing Address City Name:
WAHPETON
Provider Business Mailing Address State Name:
ND
Provider Business Mailing Address Postal Code:
58076-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
701-671-2333
Provider Business Mailing Address Fax Number:
701-671-2517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ALLIED DENTAL EDUCATION DEPARTMENT
Provider Second Line Business Practice Location Address:
800 N 6TH ST
Provider Business Practice Location Address City Name:
WAHPETON
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58076-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-671-2333
Provider Business Practice Location Address Fax Number:
701-671-2517
Provider Enumeration Date:
07/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BODENSTEINER
Authorized Official First Name:
KATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINIC COORDINATOR
Authorized Official Telephone Number:
701-671-2333

Provider Taxonomy Codes

  • Taxonomy code: 1223D0001X , with the licence number:  1754 , registered in the state of ND ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com