Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 2078 | ND |
N | 1223D0001X | Dental Public Health | 2078 | ND |
NPI | 1326354499 |
---|---|
Provider Name | Dr. Melissa Marie Eberts |
First Address | Dickinson, ND 58601-3554 |
Second Address | Dickinson, ND 58601-3554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 31/05/2013 |