# BLAKE RISTVEDT DENTAL PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1225505761
- **Authorized official:** BLAKE E RISTVEDT DDS (OWNER)
- **Authorized official phone:** (701) 866-3676

## Contact information

- **Practice address:** 520 MAIN AVE STE 705, FARGO, ND 58103-1967
- **Practice address phone:** (701) 237-4341
- **Practice address fax:** (701) 297-5938
- **Mailing address:** 520 MAIN AVE STE 705, FARGO, ND 58103-1967
- **Mailing address phone:** (701) 237-4341
- **Mailing address fax:** (701) 297-5938

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2018
- **Last updated:** 11/01/2018