Organization
PRAIRIE ROSE FAMILY DENTISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY E KING DDS (PRESIDENT)
(701) 223-1194
Entity
Organization
Contact information
Practice address
121 E FRONT AVE, BISMARCK, ND 58504-5589
(701) 223-1194
(701) 250-9614
Mailing address
121 E FRONT AVE, BISMARCK, ND 58504-5589
(701) 223-1194
(701) 250-9614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41286
—
ND
Enumeration date
11/13/2006
Last updated
08/22/2020
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