NPI 1598076119 · live from the CMS NPI Registry
Bethany L. Baillargeon Marx, DDS
Dentist in Pelican Rapids, MN. National Provider Identifier 1598076119, active.
NPI record
| NPI | 1598076119 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 22 5th Ave Ne, Pelican Rapids, MN 56572 |
| Practice phone | 218-863-7511 |
| Mailing address | 3170 44th Street South, Suite 100, Fargo, ND 58104 |
| Enumerated | June 29, 2010 |
| Last updated | January 7, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | 2232 (ND) |
| Dentist | 122300000X | 2011039028 (MO) |
| Dentist, General Practice | 1223G0001X | 6507 (WI) |
| Dentist primary | 122300000X | D13461 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.