| NPI | 1790024768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTLAND MICHAEL DRAKE Owner 605-335-6665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: SD D0632) |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2013-02-11 |