Provider Demographics
NPI:1174014526
Name:NIDER, EMILY M (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:M
Last Name:NIDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:FROSAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:232 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:HORACE
Mailing Address - State:ND
Mailing Address - Zip Code:58047-4005
Mailing Address - Country:US
Mailing Address - Phone:218-280-9753
Mailing Address - Fax:
Practice Address - Street 1:3030 49TH ST S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58104-4229
Practice Address - Country:US
Practice Address - Phone:701-237-3583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND140231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice