NPI | 1053184762 |
---|---|
Doing Business As | HOMETOWN ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | JOHN MICHAEL WELK Orthodontist 701-220-3578 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
305S00000X Point of Service | |
Enumeration Date | 2023-11-03 |
Last Update Date | 2023-11-03 |