| NPI | 1417070624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BROWER Owner 605-624-8695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M608) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD M872) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |