NPI | 1790182822 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW T WISWALL President 605-789-2017 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: SD D0827) |
Enumeration Date | 2014-12-04 |
Last Update Date | 2014-12-04 |