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Organization

DRS MOEN ENDERLE AND KREIN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARK A MOEN OD (PRESIDENT)
(701) 662-4085
Entity
Organization

Contact information

Practice address
404 HWY 2 EAST, DEVILS LAKE, ND 58301-0130
(701) 662-4085
(701) 662-6685
Mailing address
PO BOX 130, DEVILS LAKE, ND 58301-0130
(701) 662-4085
(701) 662-6685

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60573
ND
01
CI2649
PALMETTO GBA RAILROAD MEDICARE
ND
Enumeration date
09/20/2006
Last updated
08/25/2023
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