Provider Demographics
NPI:1407336084
Name:ARIE BAUER DDS, PC
Entity Type:Organization
Organization Name:ARIE BAUER DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ARIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-578-4901
Mailing Address - Street 1:501 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:ND
Mailing Address - Zip Code:58801-5327
Mailing Address - Country:US
Mailing Address - Phone:701-577-2261
Mailing Address - Fax:
Practice Address - Street 1:501 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:ND
Practice Address - Zip Code:58801-5327
Practice Address - Country:US
Practice Address - Phone:701-577-2261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIE BAUER DDS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2342261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental