| NPI | 1811031651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID RICHARD BOLTON Dentist Owner 605-334-6865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: SD M407) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD M407) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2011-09-20 |