# DAKOTA DENTAL CARE

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

## Provider details

- **NPI number:** 1225443310
- **Authorized official:** CALEB JOHNSEN (DENTIST)
- **Authorized official phone:** (701) 349-3636

## Contact information

- **Practice address:** 210 MAIN STREET, ELLENDALE, ND 58436
- **Practice address phone:** (701) 349-3636
- **Mailing address:** PO BOX 310, ELLENDALE, ND 58436-0310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 1770 | ND | — |
| 122300000X | Dentist | 2229 | ND | Yes |

## Other

- **Enumeration date:** 06/26/2014
- **Last updated:** 12/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 040501 | — | ND |
| 05 | — | 7850030 | — | SD |