Individual
BETHANY L. BAILLARGEON MARX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
22 5TH AVE NE, PELICAN RAPIDS, MN 56572-4126
(218) 863-7511
Mailing address
3170 44TH STREET SOUTH, SUITE 100, FARGO, ND 58104
(701) 235-2860
(701) 235-4179
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2011039028
MO
122300000X
Dentist
2232
ND
122300000X
Dentist
Primary
D13461
MN
1223G0001X
General Practice Dentistry
6507
WI
Other
Enumeration date
06/29/2010
Last updated
01/07/2022
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