NPI 1417288754 · live from the CMS NPI Registry
Jonathan P Dahl, DDS
Dentist in Fargo, ND. National Provider Identifier 1417288754, active.
NPI record
| NPI | 1417288754 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 1324-23rd St. S., Ste 1a, Fargo, ND 58103 |
| Practice phone | 701-238-5616 |
| Enumerated | January 27, 2010 |
| Last updated | January 27, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | 2065 (ND) |
| Dentist | 122300000X | D12757 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.