# FARGO PLASTIC SURGERY PC

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

## Provider details

- **NPI number:** 1710238233
- **Authorized official:** JOHN A. G. SAMPSON MD (OWNER)
- **Authorized official phone:** (701) 293-7408

## Contact information

- **Practice address:** 3280 20TH ST S, FARGO, ND 58104-5917
- **Practice address phone:** (701) 293-7408
- **Practice address fax:** (701) 235-2099
- **Mailing address:** 3280 20TH ST S, FARGO, ND 58104-5917
- **Mailing address phone:** (701) 293-7408
- **Mailing address fax:** (701) 235-2099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | ND | Yes |

## Other

- **Enumeration date:** 09/24/2012
- **Last updated:** 09/24/2012