Organization
SD SPECIALTY DENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CRED AND PROV REL)
(504) 638-0303
Entity
Organization
Contact information
Practice address
3813 S KIWANIS CIR, SIOUX FALLS, SD 57105-4266
(605) 332-1095
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
06/07/2024
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