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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