Provider Demographics
NPI:1538702675
Name:NORD DENTISTRY LTD
Entity type:Organization
Organization Name:NORD DENTISTRY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:NORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-772-6922
Mailing Address - Street 1:2720 17TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4008
Mailing Address - Country:US
Mailing Address - Phone:701-772-6922
Mailing Address - Fax:701-746-8080
Practice Address - Street 1:2720 17TH AVE S
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4008
Practice Address - Country:US
Practice Address - Phone:701-772-6922
Practice Address - Fax:701-746-8080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental