| Deadwood Dental | |
|
88 Charles St Deadwood SD 57732-1303 | |
| (605) 578-3810 | |
| (605) 578-3812 |
| Full Name | Deadwood Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 88 Charles St, Deadwood, South Dakota |
| Authorized Official Name and Position | Lennard Hopper (OWNER) |
| Authorized Official Contact | 6055783810 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deadwood Dental 88 Charles St Deadwood SD 57732-1303 Ph: (605) 578-3810 | Deadwood Dental 88 Charles St Deadwood SD 57732-1303 Ph: (605) 578-3810 |
| NPI Number | 1679755474 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 12/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679755474 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D0612 (South Dakota) | Primary |
Deadwood Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 88 Charles St, Deadwood, SD 57732 Phone: 605-578-3810 Fax: 605-578-3812 |