Individual
DR. DALE WAYNE BAKKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
310 SOUTH MAIN STREET, TRIPP, SD 57376-0380
(605) 935-6089
Mailing address
PO BOX 380, TRIPP, SD 57376-0380
(605) 935-6089
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M541
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803900
—
SD
Enumeration date
07/06/2007
Last updated
07/08/2007
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