Individual
DR. DANIEL L CUSTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
141 N 5TH ST, CUSTER, SD 57730-1528
(605) 673-2011
(605) 673-4529
Mailing address
141 N 5TH ST, CUSTER, SD 57730-1528
(605) 673-2011
(605) 673-4529
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M-490
SD
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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