Organization
FARGO PLASTIC SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEG S GILBERTSON (PRACTICE MANAGER)
(701) 499-4807
Entity
Organization
Contact information
Practice address
3280 20TH ST S, FARGO, ND 58104-5917
(701) 293-7480
(701) 235-2099
Mailing address
3280 20TH ST S, FARGO, ND 58104-5917
(701) 293-7480
(701) 235-2099
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
PT 12481
ND
Other
Enumeration date
08/30/2012
Last updated
09/27/2012
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