Individual
MARTIN BELANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1720 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 280-4150
Mailing address
PO BOX 2010, FARGO, ND 58122-0605
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
57097
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2085
ND
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
D12849
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720241615
—
MN
05
—
41543
—
ND
Enumeration date
07/09/2008
Last updated
12/29/2011
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