Individual
DR. BARBARA A BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2701 13TH AVE S, FARGO, ND 58103-3602
(701) 234-3620
(701) 234-3515
Mailing address
PO BOX 2010, FARGO, ND 58122-0605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10932
ND
208000000X
Pediatrics Physician
30705
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061G0BE
IPIN#
MN
05
—
14803
—
ND
01
—
251285800
MA #
MN
01
—
379000267
MPIN#
MN
Enumeration date
09/20/2006
Last updated
12/29/2011
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