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Organization

DESTINATION DENTAL PROFESSIONALS II

Active
Other names
DBA/ Destination Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA LATINOW DDS (DENTIST / OWNER)
(605) 673-2011
Entity
Organization

Contact information

Practice address
141 N 5TH ST, CUSTER, SD 57730-1528
(605) 673-2011
Mailing address
141 N 5TH ST, CUSTER, SD 57730-1528
(605) 673-2011

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M-490
SD

Other

Enumeration date
02/10/2007
Last updated
08/02/2018
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