| NPI | 1851593164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BART A SAMUELSON Owner Dentist President 605-348-4657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD D0607) |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2020-08-22 |