| NPI | 1376790626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN BRUNICK Department Chairperson 605-677-5580 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: SD D0802) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2010-08-13 |