Individual
DEXTER PERIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 S COLUMBIA RD, GRAND FORKS, ND 58201-4044
(701) 780-5270
Mailing address
526 WASHINGTON AVE, CROOKSTON, MN 56716-2060
(701) 306-1566
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R42119
ND
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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