| NPI | 1093009250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GEORGE KHAROUF Owner 605-343-4975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M839) |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2011-06-06 |