Organization
PRAIRIE ORAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALYSSA AUCK CPC (FINANCIAL COORDINATOR)
(701) 478-4404
Entity
Organization
Contact information
Practice address
1225 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(701) 478-4404
(701) 478-4407
Mailing address
2585 23RD AVE S UNIT A, FARGO, ND 58103-6172
(701) 478-4404
(701) 478-4407
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Enumeration date
02/10/2026
Last updated
02/10/2026
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