Organization
ND DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME B AUSTRIACO DDS (OWNER)
(315) 454-6000
Entity
Organization
Contact information
Practice address
1650 45TH STREET SOUTH, SUITE 108, FARGO, ND 58104
(315) 454-6000
(315) 410-5531
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(315) 454-6000
(315) 410-5531
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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