Selle, Brent Jonathon

Selle, Brent Jonathon is an individual health care provider with primary practice located at 1560 Western Dr , Dickinson ND 58601-3155. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Selle, Brent Jonathon can be contacted via phone (701) 483-9801.

Contact Information

Primary practice address
1560 Western Dr Dickinson ND 58601-3155
Phone: (701) 483-9801
Fax: (701) 483-9803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 1914 North Dakota

Profile Details

NPI number 1184629651
LBN Legal business name Selle, Brent Jonathon
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2005
Last updated May 11th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184629651 NPPES
North Dakota MEDICAID 41288
North Dakota Other V01914
North Dakota Other 01345827
North Dakota Other 901914

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