Organization
MID DAKOTA CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM HEEGAARD (PRESIDENT)
(701) 364-4554
Entity
Organization
Contact information
Practice address
401 N 9TH ST, BISMARCK, ND 58501-4507
(701) 712-4500
(701) 712-4011
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4507
(701) 712-4500
(701) 712-4011
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11238
—
ND
Enumeration date
05/19/2006
Last updated
10/25/2022
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