1101 Dental, Pllc

LBN: 1101 Dental, Pllc
1101 Dental, Pllc is an health care organization with primary practice located at 1101 S Columbia Rd Unit B, Grand Forks ND 58201-4055. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. 1101 Dental, Pllc can be contacted via phone (701) 795-1101, or through Petricig, Heather Nichole via phone (701) 795-1101.

Contact Information

Primary practice address
1101 S Columbia Rd Unit B Grand Forks ND 58201-4055
Phone: (701) 795-1101
Fax: (701) 795-1102
Website:
Map and Directions
Authorized official contact:
Name: Petricig, Heather Nichole Doctor of Dental Surgery (DDS)
Phone: (701) 795-1101

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2083 North Dakota

Profile Details

NPI number 1750689030
LBN Legal business name 1101 Dental, Pllc
DBA Doing business as
Authorized official Petricig, Heather Nichole Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 10th, 2011
Last updated Mar 10th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750689030 NPPES
North Dakota MEDICAID 41566

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