| NPI | 1235421702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS L CRIST CEO 605-361-0016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD M842) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |