# PRAIRIE ROSE FAMILY DENTISTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144391632
- **Authorized official:** DR. BRADLEY E KING DDS (PRESIDENT)
- **Authorized official phone:** (701) 223-1194

## Contact information

- **Practice address:** 121 E FRONT AVE, BISMARCK, ND 58504-5589
- **Practice address phone:** (701) 223-1194
- **Practice address fax:** (701) 250-9614
- **Mailing address:** 121 E FRONT AVE, BISMARCK, ND 58504-5589
- **Mailing address phone:** (701) 223-1194
- **Mailing address fax:** (701) 250-9614

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41286 | — | ND |