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Organization

PLATTE DENTAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LANCE R. GRIESE DDS (DDS)
(605) 337-3810
Entity
Organization

Contact information

Practice address
601 E. 7TH ST., STE #5, PLATTE, SD 57369-0250
(605) 337-3810
(605) 337-2617
Mailing address
PO BOX 250, 601 E. 7TH ST. STE #5, PLATTE, SD 57369-0250
(605) 337-3810
(605) 337-2617

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M683
SD
1223G0001X
General Practice Dentistry
M925
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025648200
NE
05
7805980
SD
Enumeration date
11/22/2011
Last updated
11/22/2011
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