| NPI | 1942334727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD BOYD WHILLOCK Periodontist 605-348-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist Periodontics (Licence: SD M-347) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |