Full Name | |
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Speciality | Clinic/center - Dental |
Location | 111 Iowa St, Alcester, South Dakota |
Authorized Official Name and Position | John Mengenhausen (CEO) |
Authorized Official Contact | 6057724525 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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602 1st St Ne Ste 1 Wessington Springs SD 57382-2163 Ph: (605) 539-9836 | 111 Iowa St Alcester SD 57001 Ph: (605) 934-2251 |
NPI Number | 1245769447 |
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Provider Enumeration Date | 06/09/2017 |
Last Update Date | 06/09/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245769447 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |