Individual
DR. VITALY PERETS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4603 W HOMEFIELD DR, SIOUX FALLS, SD 57106-3511
(605) 275-2424
Mailing address
1812 S STRABANE CIR, SIOUX FALLS, SD 57106-4512
(817) 807-7073
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1194
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1194
DENTIST LICENSE NUMBER
SD
Enumeration date
06/07/2018
Last updated
06/07/2018
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