Organization
FACE & JAW SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH DEATHERAGE DMD, MD (SURGEON, OWNER)
(701) 258-7220
Entity
Organization
Contact information
Practice address
664 12TH ST W, DICKINSON, ND 58601
(701) 258-7220
(701) 222-2329
Mailing address
1730 BURNT BOAT DR STE 300, BISMARCK, ND 58503
(701) 258-7220
(701) 222-2329
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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