Individual
MRS. ANITA MARIE MASAITIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
210 1ST ST, WANBLEE HEALTH CENTER, WANBLEE, SD 57577
(605) 462-5630
(605) 462-6631
Mailing address
PO BOX 40760, MESA, AZ 85274
(480) 706-9430
(480) 461-1785
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
016.0101177
VT
122300000X
Dentist
Primary
2302
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016.0101177
DENTAL LICENSE
VT
01
—
2302
LICENSE
MT
Enumeration date
07/24/2008
Last updated
07/15/2021
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