Organization
BLAKE RISTVEDT DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE E RISTVEDT DDS (OWNER)
(701) 866-3676
Entity
Organization
Contact information
Practice address
520 MAIN AVE STE 705, FARGO, ND 58103-1967
(701) 237-4341
(701) 297-5938
Mailing address
520 MAIN AVE STE 705, FARGO, ND 58103-1967
(701) 237-4341
(701) 297-5938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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