| NPI | 1023192127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE A EVANS Owner Orthodontist 605-342-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M719) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M914) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M267) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |