NPI | 1396836466 |
---|---|
Entity Type | Organization |
Authorized Contact | JAY W SEGRIST President 605-716-7509 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD M960) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2020-08-22 |