| NPI | 1568794592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA HRISTINE LATINOW Dentist/President 605-765-9674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD D0902) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2010-02-01 |