Northeastern Dental Center | |
102 8th Ave S Faulkton SD 57438-2115 | |
(605) 598-4452 | |
(605) 598-4280 |
Full Name | Northeastern Dental Center |
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Speciality | Dentist - General Practice |
Location | 102 8th Ave S, Faulkton, 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 |
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Northeastern Dental Center Po Box 534 Faulkton SD 57438-0534 Ph: (605) 598-4452 | Northeastern Dental Center 102 8th Ave S Faulkton SD 57438-2115 Ph: (605) 598-4452 |
NPI Number | 1932418480 |
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Provider Enumeration Date | 10/01/2010 |
Last Update Date | 12/22/2010 |
Identifier | Type | State | Issuer |
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1932418480 | NPI | - | NPPES |
7805395 | Medicaid | SD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | M664 (South Dakota) | Primary |