| Organization Name: | DGB DENTAL |
| NPI Number: | 1033512660 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID G BRANT (OWNER) |
| Mailing Address: | 15 E 7th St Grafton |
| State: | ND US |
| Postal Code: | 582372313 |
| Phone Number: | 7013520730 |
| Fax Number: | 7013520902 |
| NPI Enumeration Date: | 09/26/2014 |
| NPI Last Update Date: | 09/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 1617 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |