Individual
DR. DANIEL LAWRENCE MENGEDOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2585 23RD AVE S, SUITE C, FARGO, ND 58103-6172
(701) 356-1280
(701) 356-1281
Mailing address
2585 23RD AVE, SUITE C, FARGO, ND 58103
(701) 356-1280
(701) 356-1281
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2087
ND
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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