Organization
GREAT PLAINS CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY S ROSHAU (OFFICE SUPERVISOR)
(701) 456-5115
Entity
Organization
Contact information
Practice address
33 9TH ST W, DICKINSON, ND 58601-3950
(701) 483-6017
(701) 483-5018
Mailing address
33 9TH ST W, DICKINSON, ND 58601-3950
(701) 483-6017
(701) 483-5018
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17984
—
ND
Enumeration date
06/22/2007
Last updated
06/18/2009
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