| NPI | 1487718565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL M KIMBLER Owner 605-225-9362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SD M862) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: SD SD4237) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2013-03-25 |