| NPI | 1194903567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA LYNN HELLER Office Manager 605-886-8096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD DO609) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2008-08-26 |