Individual
BETHANY R NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
101 MERRILL AVE, BOX 1010, NORTH SIOUX CITY, SD 57049
(605) 232-8802
(605) 232-0973
Mailing address
320 DAKOTA DUNES BLVD, APT #108, DAKOTA DUNES, SD 57049-5340
(605) 422-1413
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D0615
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0722009
—
IA
05
—
46044478600
—
SD
05
—
46044478613
—
NE
Enumeration date
10/19/2006
Last updated
07/08/2007
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