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Organization
NORTH DAKOTA SURGERY CENTER, LLC
Active
Organization
NORTH DAKOTA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5935
Entity
Organization
Contact information
Practice address
2600 47TH AVE SOUTH, GRAND FORKS, ND 58201
(701) 738-4248
(701) 775-3153
Mailing address
3035 DEMERS AVE, GRAND FORKS, ND 58201-4040
(701) 738-4240
(701) 775-3153
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
35C0001011
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10202
—
ND
Enumeration date
06/23/2005
Last updated
02/19/2020
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