| NPI | 1326787094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS L JOHNSON President 605-663-4865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2022-06-01 |