NPI 1043467152

Jackie Rae Nord, DDS

Practitioner Dentist Grand Forks, ND

Practice location

Address: 212 S 4th St Suite 101, Grand Forks, ND 58201-4777
Phone: (701) 757-2100
Mailing address: 212 S 4th St STE 200, Grand Forks, ND 58201-4781

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 2108 (ND)

Other Dentist providers in North Dakota →

Registry record

NPI: 1043467152
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Aug 2008
Record last updated: 14 Oct 2019

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.