| The Dental Clinic | |
|
621 2nd Street Bridgewater SD 57319 | |
| (605) 729-2671 | |
| (605) 729-2671 |
| Full Name | The Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 621 2nd Street, Bridgewater, South Dakota |
| Authorized Official Name and Position | Amber A Determan (OWNER PARTNER) |
| Authorized Official Contact | 6057292671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dental Clinic Po Box 100 621 2nd Street Bridgewater SD 57319 Ph: (605) 729-2671 | The Dental Clinic 621 2nd Street Bridgewater SD 57319 Ph: (605) 729-2671 |
| NPI Number | 1134330665 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134330665 | NPI | - | NPPES |
| 7800550 | Medicaid | SD | |
| 7801500 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (South Dakota) | Primary |