# SPIRIT LAKE TRIBE

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPIRIT LAKE TRIBE
- **Other names:** Spirit Lake Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1508317090
- **Legal business name:** SPIRIT LAKE TRIBE
- **Authorized official:** MICHELLE BELT (CEO)
- **Authorized official phone:** (701) 766-1600

## Contact information

- **Practice address:** 3883 74TH AVE NE, FORT TOTTEN, ND 58335
- **Practice address phone:** (701) 766-1600
- **Practice address fax:** (701) 766-1630
- **Mailing address:** PO BOX 309, FORT TOTTEN, ND 58335-0309
- **Mailing address phone:** (701) 766-1600
- **Mailing address fax:** (701) 766-1630

## Taxonomy

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

## Other

- **Enumeration date:** 10/19/2016
- **Last updated:** 10/19/2016