Provider Demographics
NPI:1891077921
Name:ROBERT REMMICK, DDS, PC
Entity Type:Organization
Organization Name:ROBERT REMMICK, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REMMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-662-8980
Mailing Address - Street 1:PO BOX 673
Mailing Address - Street 2:
Mailing Address - City:DEVILS LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58301-0673
Mailing Address - Country:US
Mailing Address - Phone:701-662-8980
Mailing Address - Fax:701-662-8504
Practice Address - Street 1:310 4TH ST NW
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301
Practice Address - Country:US
Practice Address - Phone:701-662-8980
Practice Address - Fax:701-662-8504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND20331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND40014Medicaid