# HEARTLAND DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evergreen Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659399517
- **Authorized official:** DR. CASEY DEAN FINES DDS (OWNER/DENTIST)
- **Authorized official phone:** (701) 237-6307

## Contact information

- **Practice address:** 1213 19TH AVE N, FARGO, ND 58102-2242
- **Practice address phone:** (701) 237-6307
- **Mailing address:** 1213 19TH AVE N, FARGO, ND 58102-2242
- **Mailing address phone:** (701) 237-6307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 1949 | ND | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 07/21/2022