Organization
MID DAKOTA CLINIC MAMMOGRAPHY
Active
Parent organization
MID DAKOTA CLINIC, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
MID DAKOTA CLINIC, INC.
Authorized official
MR. WILLIAM HEEGAARD (PRESIDENT)
(701) 364-4554
Entity
Organization
Contact information
Practice address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 530-6000
(701) 530-6430
Mailing address
401 N 9TH ST, BISMARCK, ND 58501-4530
(701) 530-6000
(701) 530-6430
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
125369
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125369
CLIA #
—
Enumeration date
05/09/2007
Last updated
10/25/2022
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