| NPI | 1356546394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES S. NELSON Owner 605-341-3670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M676) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD M689) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2020-08-22 |