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Organization
PREVENTATIVE DENTAL LLC
Active
Organization
PREVENTATIVE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE MYERS (OFFICE MANAGER)
(605) 868-2191
Entity
Organization
Contact information
Practice address
1155 4TH ST NE, WATERTOWN, SD 57201-1202
(605) 882-3060
(605) 882-0681
Mailing address
1155 4TH ST NE, WATERTOWN, SD 57201-1202
(605) 882-3060
(605) 882-0681
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M983
SD
Other
Enumeration date
05/21/2015
Last updated
05/21/2015
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