Organization
DAKOTA COLLEGE AT BOTTINEAU
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MATTSON (CONTROLLER)
(701) 228-5433
Entity
Organization
Contact information
Practice address
120 BURDICK EXPY E, MINOT, ND 58701-4434
(701) 858-3184
Mailing address
105 SIMRALL BLVD, BOTTINEAU, ND 58318-1198
(701) 228-5433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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