| NPI | 1861545626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK R HERMANSON Owner 605-224-5966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-12-04 |