Provider First Line Business Practice Location Address:
PRAIRIE ROSE FAMILY DENTISTS
Provider Second Line Business Practice Location Address:
121 E. FRONT AVENUE
Provider Business Practice Location Address City Name:
BISMARCK
Provider Business Practice Location Address State Name:
ND
Provider Business Practice Location Address Postal Code:
58504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
701-223-1194
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/26/2005