Organization
BEULAH DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN B LEE DDS (PRESIDENT)
(701) 873-2259
Entity
Organization
Contact information
Practice address
200 W MAIN ST, BEULAH, ND 58523-6970
(701) 873-2259
Mailing address
PO BOX 118, BEULAH, ND 58523-0118
(701) 873-2259
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457382
—
ND
Enumeration date
12/03/2015
Last updated
12/03/2015
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