Organization
FAMILY DENTISTS PROF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. (JAY) JOHN ARTHUR BENUSIS DDS (OFFICER)
(605) 341-5437
Entity
Organization
Contact information
Practice address
812 COLUMBUS ST, RAPID CITY, SD 57701
(605) 341-5437
Mailing address
812 COLUMBUS ST., RAPID CITY, SD 57701
(605) 341-5437
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D803
SD
Other
Enumeration date
02/03/2011
Last updated
02/03/2011
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