| NPI | 1922196955 |
|---|---|
| Doing Business As | PRAIRIE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | JUSTIN M. NICHOLS Dentist/Owner 605-335-8640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: SD M631) |
| Additional Taxonomies | 122300000X Dentist (Licence: SD D0522) |
| 122300000X Dentist (Licence: SD D1051) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2014-09-25 |