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LAMAR WILBUR KOISTINEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
401 PRAIRIE AVE SW, DESMET, SD 57231
(605) 854-3455
(605) 854-9952
Mailing address
401 PRAIRIE AVE SW, PO BOX 49, DESMET, SD 57231
(605) 854-3455
(605) 854-9952

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
413
SD

Other

Enumeration date
06/06/2013
Last updated
06/30/2014
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