Provider Demographics
NPI:1356630131
Name:BYRUM CARTWRIGHT DDS PC
Entity Type:Organization
Organization Name:BYRUM CARTWRIGHT DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BYRUM
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:CARTWRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-293-0751
Mailing Address - Street 1:2534 UNIVERSITY DRIVE SOUTH
Mailing Address - Street 2:SUITE 3
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-293-0751
Mailing Address - Fax:701-293-6158
Practice Address - Street 1:2534 UNIVERSITY DRIVE SOUTH
Practice Address - Street 2:SUITE 3
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-293-0751
Practice Address - Fax:701-293-6158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty