| NPI | 1356452916 |
|---|---|
| Doing Business As | NORTHEASTERN DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | GREGG EDWARD VAN BEEK Dentist Owner 605-226-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M664) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2020-08-22 |