Organization
PEDIATRIC DENTISTRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLE V NELSON DDS (PRESIDENT)
(605) 338-0884
Entity
Organization
Contact information
Practice address
1737 S CLEVELAND AVE, SIOUX FALLS, SD 57103-3245
(605) 338-0884
(605) 338-0240
Mailing address
1737 S CLEVELAND AVE, SIOUX FALLS, SD 57103-3245
(605) 338-0884
(605) 338-0240
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
M442
SD
Other
Enumeration date
08/20/2007
Last updated
08/20/2007
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