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Contact Information

GOOSE RIVER DENTAL ASSOC., PC
37 1/2 MAIN ST E
MAYVILLE, ND58257
 Phone: 701-788-4064
 Fax: 701-788-9090
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for GOOSE RIVER DENTAL ASSOC., PC

NPI # 1164522306
LBN Legal business name GOOSE RIVER DENTAL ASSOC., PC
Authorized official ROBERT LAUF - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
ND Medicaid 41080
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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