# PARKSIDE DENTAL PC

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

## Provider details

- **NPI number:** 1588838106
- **Authorized official:** DR. LOWELL L CHENEY DMD (PRESIDENT)
- **Authorized official phone:** (701) 852-5333

## Contact information

- **Practice address:** 701 3RD ST NE, MINOT, ND 58703-2401
- **Practice address phone:** (701) 852-5333
- **Mailing address:** 701 3RD ST NE, MINOT, ND 58703-2401

## Taxonomy

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

## Other

- **Enumeration date:** 04/15/2008
- **Last updated:** 04/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 41332 | — | ND |