| NPI | 1992523146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BORTNEM Owner, Orthodontist 605-999-1619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2024-09-27 |
| Last Update Date | 2024-09-27 |