Organization
MCCLELLAN-SWANSON DENTAL CLINC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC HERBERT MCCLELLAN D.D.S. (PARTNER-SHAREHOLDER)
16058457222
Entity
Organization
Contact information
Practice address
509 N MAIN ST, MOBRIDGE, SD 57601-2130
(605) 845-7222
(605) 845-5532
Mailing address
509 N MAIN ST, MOBRIDGE, SD 57601-2130
(605) 845-7222
(605) 845-5532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M711
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7805820
—
SD
Enumeration date
11/06/2006
Last updated
08/22/2020
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