Organization
NORTH DAKOTA SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER BOYD BALDOCK (OFFICER AND AUTHORIZED OFFICIAL)
(615) 234-5935
Entity
Organization
Contact information
Practice address
2600 47TH AVE SOUTH, GRAND FORKS, ND 58201
(701) 738-4248
(701) 775-3153
Mailing address
3035 DEMERS AVE, GRAND FORKS, ND 58201-4040
(701) 738-4240
(701) 775-3153
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
35C0001011
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10202
—
ND
Enumeration date
06/23/2005
Last updated
02/19/2020
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