NPI 1013652395

Coulton Dangerfield

Practitioner Dentist Fargo, ND

Practice location

Address: 1231 27th St S STE C, Fargo, ND 58103-8722
Phone: (701) 232-6983
Mailing address: 1354 6th St NW, West Fargo, ND 58078-3804

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 2467 (ND)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013652395
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 May 2022
Record last updated: 13 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.