South University Dental Associates, PC

NPI #1043514367 in Fargo, North Dakota

Provider Information

NPI Number: 1043514367
Entity Type: Organization
Organization Name: South University Dental Associates, PC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Dec 29, 2010
Last Updated: Dec 29, 2010

Practice Location

Address: 3115 UNIVERSITY DR S
City: Fargo
State: North Dakota
ZIP Code: 58103-6049
Phone: (701) 232-8884

Authorized Official

Name: DR. THOMAS GLEN FELLMAN, DDS
Title: PRESIDENT
Phone: (701) 232-8884

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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