Organization
ORTHODONTIC ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY D TOWNSEND HANSEN DDS (ORTHODONTIST)
(701) 237-3725
Entity
Organization
Contact information
Practice address
1017 N BROADWAY, FARGO, ND 58102-3645
(701) 237-3725
(701) 237-3276
Mailing address
1017 N BROADWAY, FARGO, ND 58102-3645
(701) 237-3725
(701) 237-3276
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
1562
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1562
LICENSE
ND
01
—
8077
AAO
—
01
—
D8091
LICENSE
MN
Enumeration date
02/16/2007
Last updated
08/22/2020
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