NPI | 1497956304 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK C BERDAHL President 605-332-4751 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: SD M911) |
Additional Taxonomies | 122300000X Dentist (Licence: SD M687) |
Enumeration Date | 2007-05-29 |
Last Update Date | 2020-08-22 |