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Individual

MR. DUSTIN ADAM EDDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CPS

Contact information

Practice address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900
Mailing address
1237 W DIVIDE AVE STE 5, BISMARCK, ND 58501-1208
(701) 328-8888
(701) 328-8900

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
ND

Other

Enumeration date
09/16/2022
Last updated
09/19/2022
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