# PRAIRIE DENTAL INC

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

## Provider details

- **NPI number:** 1942579081
- **Authorized official:** JENNIFER SARSLAND DDS (DENTIST)
- **Authorized official phone:** (701) 523-3255

## Contact information

- **Practice address:** 608 HIGHWAY 12 W, BOWMAN, ND 58623-4507
- **Practice address phone:** (701) 523-3255
- **Practice address fax:** (701) 523-5742
- **Mailing address:** PO BOX 710, BOWMAN, ND 58623-0710
- **Mailing address phone:** (701) 523-3255
- **Mailing address fax:** (701) 523-5742

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2101 | ND | Yes |
| 124Q00000X | Dental Hygienist | — | NULL | — |
| 124Q00000X | Dental Hygienist | — | — | — |
| 126800000X | Dental Assistant | — | NULL | — |
| 126800000X | Dental Assistant | — | — | — |

## Other

- **Enumeration date:** 12/19/2011
- **Last updated:** 12/19/2011