ETERN S PARK DDS, MD
Individual Provider (NPI-1)
Active
Dentist, Oral and Maxillofacial Surgery
Provider Information
- NPI Number
1124289905- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DDS, MD
- Status
- Active
Contact & Location
- Address
- 1717 UNIVERSITY DR S, FARGO, ND, 581034939
- Phone
- (701) 234-2000
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Surgery
License: ND #2503
Dentist, Oral and Maxillofacial Surgery
License: DE #C1-0011804
Dentist, Oral and Maxillofacial Surgery
License: DE #G3-0000458
Oral & Maxillofacial Surgery
License: ND #21037
Oral & Maxillofacial Surgery
License: NY #269333
Dentist, Oral and Maxillofacial Surgery
Primary License: NY #053210