Organization
LIFETIME DENTAL PARTNERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA LEA EKMAN DDS (OWNER)
(701) 352-2450
Entity
Organization
Contact information
Practice address
321 BRIGGS AVE S, SUITE 3, PARK RIVER, ND 58270
(701) 284-7777
(701) 284-6776
Mailing address
927 W 12TH ST, GRAFTON, ND 58237-2121
(701) 352-2450
(701) 352-2424
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
1904
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1458306
—
ND
Enumeration date
07/31/2014
Last updated
01/11/2024
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