Provider Demographics
NPI:1154458446
Name:TRONSGARD, PAUL JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JAMES
Last Name:TRONSGARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 27TH ST S STE C
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8722
Mailing Address - Country:US
Mailing Address - Phone:701-232-6983
Mailing Address - Fax:701-239-9375
Practice Address - Street 1:1231 27TH ST S STE C
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-8722
Practice Address - Country:US
Practice Address - Phone:701-232-6983
Practice Address - Fax:701-239-9375
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1796122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1457269Medicaid
ND41076Medicaid