Organization
NORTHEAST ORTHODONTIC ASSOCIATES. L.L.C.
Active
Organization
NORTHEAST ORTHODONTIC ASSOCIATES. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN K VAN LAECKEN D.D.S., M.S. (OWNER)
(605) 882-2772
Entity
Organization
Contact information
Practice address
25 5TH ST NE, WATERTOWN, SD 57201-3712
(605) 882-1500
(605) 882-7090
Mailing address
25 5TH ST NE, P O BOX 1450, WATERTOWN, SD 57201-3712
(605) 882-1500
(605) 882-7090
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
M817
SD
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up