Individual
DR. MARK CLINTON NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
465 S PIERRE STREET, PIERRE, SD 57501-4507
(605) 224-7774
(605) 224-9171
Mailing address
465 S PIERRE STREET, PIERRE, SD 57501-4507
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M607
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7804160
—
SD
Enumeration date
04/23/2007
Last updated
07/08/2007
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