# DAKOTA CLINIC, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dakota Clinic, Ltd. at Innovis
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194777409
- **Authorized official:** LARRY G SOLBERG (ADMINISTRATOR-AUTHORIZED OFFICIAL)
- **Authorized official phone:** (701) 364-3405

## Contact information

- **Practice address:** 3000 32ND AVE S, FARGO, ND 58103-6132
- **Practice address phone:** (701) 364-8000
- **Practice address fax:** (701) 364-8078
- **Mailing address:** PO BOX 6001, FARGO, ND 58108-6001
- **Mailing address phone:** (701) 364-8000
- **Mailing address fax:** (701) 364-8078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10046 | — | ND |