Organization
MARK A BIERSCHBACH D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALAN BIERSCHBACH D.D.S (DENTIST)
(605) 432-5032
Entity
Organization
Contact information
Practice address
1203 EAST 4TH AVE., SUITE 103, MILBANK, SD 57252
(605) 432-5032
(605) 432-4844
Mailing address
PO BOX 592, MILBANK, SD 57252-0592
(605) 432-5032
(605) 432-4844
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M482
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7801810
—
SD
01
—
837660
UNITED CONCORDIA/TRICARE
—
01
—
989074
BLUECROSS BLUESHIED OF ND
ND
Enumeration date
10/17/2006
Last updated
08/22/2020
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