| NPI | 1477748275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS DALE MCKINNEY Dentist/Doctor 605-339-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: SD M841) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SD M867) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2014-04-09 |