Individual
DR. NICHOLAS RYAN BAKKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
204 2ND AVE NE, HAZEN, ND 58545-4420
(701) 748-2730
Mailing address
204 2ND AVE NE, HAZEN, ND 58545-4420
(701) 748-2730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2018
ND
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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