Selle, Brent Jonathon
Selle, Brent Jonathon is an individual health care provider with primary practice located at 1560 Western Dr , Dickinson ND 58601-3155. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Selle, Brent Jonathon can be contacted via phone (701) 483-9801.Contact Information
Primary practice address
1560 Western Dr
Dickinson ND 58601-3155
Phone: (701) 483-9801
Fax: (701) 483-9803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 1914 | North Dakota |
Profile Details
| NPI number | 1184629651 |
|---|---|
| LBN Legal business name | Selle, Brent Jonathon |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2005 |
| Last updated | May 11th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184629651 | NPPES |
| North Dakota | MEDICAID | 41288 | |
| North Dakota | Other | V01914 | |
| North Dakota | Other | 01345827 | |
| North Dakota | Other | 901914 |
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