Individual
VICTOR ISAIAH MASTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(775) 895-5667
Mailing address
2915 BLUESTEM DR APT 1158, WEST FARGO, ND 58078-8027
(775) 895-5667
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
2010
ND
Other
Enumeration date
12/17/2024
Last updated
12/17/2024
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