| NPI | 1194679704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CODY JOHN JORDAN Oral Surgeon 701-699-6966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2026-02-23 |
| Last Update Date | 2026-02-23 |