| Northeastern Dental Center | |
|
3015 6th Ave Se Suite #12 Aberdeen SD 57401-5461 | |
| (605) 226-3939 | |
| (605) 226-3428 |
| Full Name | Northeastern Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3015 6th Ave Se, Aberdeen, South Dakota |
| Authorized Official Name and Position | Gregg Van Beek (OWNER) |
| Authorized Official Contact | 6052263939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeastern Dental Center 3015 6th Ave Se Suite #12 Aberdeen SD 57401-5461 Ph: (605) 226-3939 | Northeastern Dental Center 3015 6th Ave Se Suite #12 Aberdeen SD 57401-5461 Ph: (605) 226-3939 |
| NPI Number | 1932403938 |
|---|---|
| Provider Enumeration Date | 01/05/2011 |
| Last Update Date | 01/05/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932403938 | NPI | - | NPPES |
| 7805395 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | M664 (South Dakota) | Primary |
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Northeastern Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3015 6th Ave Se, Suite 12, Aberdeen, SD 57401 Phone: 605-226-3939 Fax: 605-226-3428 |