Organization
DRS MOEN ENDERLE AND KREIN PC
Active
Parent organization
DRS MOEN ENDERLE AND KREIN PC
Other names
20/20 EyeCare
Organization subpart
Yes
Provider details
NPI number
Legal business name
DRS MOEN ENDERLE AND KREIN PC
Authorized official
DR. BLAINE BURDICK (OPTOMETRIST)
(701) 662-2040
Entity
Organization
Contact information
Practice address
211 4TH ST NE STE 1, DEVILS LAKE, ND 58301-2479
(701) 662-2040
(701) 662-2040
Mailing address
PO BOX 888, DEVILS LAKE, ND 58301-0888
(701) 662-2040
(701) 662-2040
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
675
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60570
—
ND
05
—
60678
—
ND
01
—
893212
VSI
ND
01
—
N70449
MEDICARE ID GROUP
ND
Enumeration date
10/30/2007
Last updated
03/05/2024
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