Dba/ Destination Dentistry | |
141 N 5th St Custer SD 57730-1528 | |
(605) 673-2011 | |
Not Available |
Full Name | Dba/ Destination Dentistry |
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Speciality | Dentist - General Practice |
Location | 141 N 5th St, Custer, South Dakota |
Authorized Official Name and Position | Diana Latinow (DENTIST / OWNER) |
Authorized Official Contact | 6056732011 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Dba/ Destination Dentistry 141 N 5th St Custer SD 57730-1528 Ph: (605) 673-2011 | Dba/ Destination Dentistry 141 N 5th St Custer SD 57730-1528 Ph: (605) 673-2011 |
NPI Number | 1043351018 |
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Provider Enumeration Date | 02/10/2007 |
Last Update Date | 08/02/2018 |
Identifier | Type | State | Issuer |
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1043351018 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | M-490 (South Dakota) | Primary |
Sleep Better South Dakota Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 N 5th St, Custer, SD 57730 Phone: 605-389-3289 | |
Custer Dental Studio Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 N 5th St, Custer, SD 57730 Phone: 605-321-2086 |