Organization
GREAT NORTHERN DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CLAYBURGH DDS (DOCTOR)
(701) 772-8488
Entity
Organization
Contact information
Practice address
667 DEMERS AVE STE 1002, GRAND FORKS, ND 58201-4500
(701) 772-8488
Mailing address
667 DEMERS AVE, STE 1002, GRAND FORKS, ND 58201
(701) 772-8488
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
1688
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1456616
—
SD
Enumeration date
11/20/2015
Last updated
11/20/2015
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