Organization
BISMARCK DERMATOLOGY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA BOSCH (BUSINESS MANAGER)
(701) 220-4858
Entity
Organization
Contact information
Practice address
4207 BOULDER RIDGE RD, BISMARCK, ND 58503-6163
(701) 673-3376
Mailing address
4207 BOULDER RIDGE RD, BISMARCK, ND 58503-6163
(701) 673-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952360711
NPI
ND
Enumeration date
02/22/2021
Last updated
02/22/2021
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