Provider Demographics
NPI:1386346187
Name:ANEW ORAL SURGERY PLLC
Entity type:Organization
Organization Name:ANEW ORAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:701-707-3720
Mailing Address - Street 1:1918 9TH ST E STE B
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8004
Mailing Address - Country:US
Mailing Address - Phone:701-707-3720
Mailing Address - Fax:701-707-3727
Practice Address - Street 1:1918 9TH ST E STE B
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8004
Practice Address - Country:US
Practice Address - Phone:701-707-3720
Practice Address - Fax:701-707-3727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty