Provider Demographics
NPI:1871887802
Name:DUBE, NOMUHLE SANELISIWE (DDS)
Entity type:Individual
Prefix:DR
First Name:NOMUHLE
Middle Name:SANELISIWE
Last Name:DUBE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S 4TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4776
Mailing Address - Country:US
Mailing Address - Phone:701-757-2100
Mailing Address - Fax:701-757-2103
Practice Address - Street 1:212 S 4TH ST STE 101
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-4776
Practice Address - Country:US
Practice Address - Phone:701-757-2100
Practice Address - Fax:701-757-2103
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice