| NPI | 1063618015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE M DANA President 605-717-2722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M961) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2020-08-22 |