NPI | 1043351018 |
---|---|
Doing Business As | DBA/ DESTINATION DENTISTRY |
Entity Type | Organization |
Authorized Contact | DIANA LATINOW Dentist / Owner 605-673-2011 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD M-490) |
Enumeration Date | 2007-02-10 |
Last Update Date | 2018-08-02 |