Organization
DR DUANE KRIVARCHKA, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BERGEMANN (OFFICE MANAGER)
(701) 683-4455
Entity
Organization
Contact information
Practice address
11 11TH AVE W, LISBON, ND 58054
(701) 683-4455
Mailing address
PO BOX 233, 11 11TH AVE W, LISBON, ND 58054
(701) 683-4455
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1677
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40908
—
ND
Enumeration date
05/09/2014
Last updated
05/09/2014
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