Individual
MR. JEROME WAYNE BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 E 7TH ST, PLATTE, SD 57369-2123
(605) 337-1501
(605) 337-3360
Mailing address
PO BOX 818, PLATTE, SD 57369-0818
(605) 337-1501
(605) 337-3360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1337
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5602593
—
SD
05
—
5602594
—
SD
Enumeration date
06/01/2005
Last updated
05/28/2021
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