Provider Demographics
NPI:1912484189
Name:NORTH DAKOTA DEPARTMENT OF HEALTH
Entity Type:Organization
Organization Name:NORTH DAKOTA DEPARTMENT OF HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WEISZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-328-2392
Mailing Address - Street 1:600 E BOULEVARD AVE, DEPT 301
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58505-0200
Mailing Address - Country:US
Mailing Address - Phone:701-328-2356
Mailing Address - Fax:701-328-2036
Practice Address - Street 1:600 E BOULEVARD AVE, DEPT 301
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58505-0200
Practice Address - Country:US
Practice Address - Phone:701-328-4930
Practice Address - Fax:701-328-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty