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Organization
PRAIRIE ORAL SURGERY LTD
Active
Organization
PRAIRIE ORAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETH MARIE JAROSZEWSKI (FINANCE COORDINATOR)
(701) 478-4404
Entity
Organization
Contact information
Practice address
2585 23RD AVE S, STE A., FARGO, ND 58103
(701) 478-4404
(701) 478-4407
Mailing address
2585 23RD AVE S, STE. A., FARGO, ND 58104
(701) 478-4404
(701) 478-4407
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
ND
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
07/08/2005
Last updated
07/21/2022
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