Organization
MAPLE FAMILY DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BULTEMA D.D.S (PRESIDENT)
(701) 552-6001
Entity
Organization
Contact information
Practice address
594 MAIN ST N, HORACE, ND 58047-4640
(701) 552-6001
Mailing address
594 MAIN ST N, HORACE, ND 58047-4640
(701) 552-6001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2046
ND
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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