Provider Demographics
NPI:1295904670
Name:DEETER & DEETER DENTISTRY PARTNERSHIP
Entity type:Organization
Organization Name:DEETER & DEETER DENTISTRY PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEETER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-222-1800
Mailing Address - Street 1:745 W INTERSTATE AVE
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-0936
Mailing Address - Country:US
Mailing Address - Phone:701-222-1800
Mailing Address - Fax:
Practice Address - Street 1:745 W INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0936
Practice Address - Country:US
Practice Address - Phone:701-222-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty