# NORTHCREEK DENTAL PC

> 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
- **Other names:** Lidgerwood Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669917308
- **Authorized official:** DR. MARK SCHAFFER DDS (OWER/DENTISH)
- **Authorized official phone:** (701) 242-7140

## Contact information

- **Practice address:** 19 WILEY AVE, LIDGEWOOD, ND 58053
- **Practice address phone:** (701) 538-4583
- **Practice address fax:** (701) 538-4560
- **Mailing address:** 17060 HWY 46, HORACE, ND 58047

## Taxonomy

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

## Other

- **Enumeration date:** 01/05/2017
- **Last updated:** 01/05/2017