Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETERN S PARK, DDS, MD
ActiveETERN S PARK, DDS, MD is a Oral & Maxillofacial Surgery healthcare provider located in FARGO, North Dakota. NPI 1124289905 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · FARGO, ND
Registration Details
- NPI Number
- 1124289905
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 24, 2008 (18.098203591443 yrs)
- Last Updated
- Feb 11, 2025
- Licenses
-
2503 (ND)C1-0011804 (DE)G3-0000458 (DE)21037 (ND)269333 (NY)
Practice Information
- Address
-
1717 UNIVERSITY DR SFARGO, ND, 581034939Browse ND providers · Browse ZIP 58103
- Phone
- 7012342000
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery
- Additional Specialty
- Oral & Maxillofacial Surgery
- Additional Specialty
- Oral & Maxillofacial Surgery (Physician)
- Additional Specialty
- Oral & Maxillofacial Surgery (Physician)
Other Oral & Maxillofacial Surgery Providers in FARGO, ND
| Name | Credential | NPI |
|---|---|---|
| MICHAEL J NOFFZE | DDS | 1538147848 |
| PAUL H IVERSON | DDS | 1467487298 |
| SCOTT A PREISLER | DDS, MS | 1780761031 |
| CHARLES A CRAGO | DMD, MD | 1629147723 |
| RYAN J SMART | DMD | 1386849446 |
| DR. FRANK RUSSELL NEWMAN JR. | D.M.D. | 1548454085 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.