Individual
DR. JACKIE RAE NORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
212 S 4TH ST, SUITE 101, GRAND FORKS, ND 58201-4777
(701) 757-2100
Mailing address
212 S 4TH ST STE 200, GRAND FORKS, ND 58201-4781
(701) 757-2100
(701) 757-0305
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2108
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043467152
—
MN
05
—
40011
—
ND
Enumeration date
08/20/2008
Last updated
10/14/2019
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