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Organization

NORTH SIOUX DENTAL CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD B CORK JR. DDS (GENERAL DENTIST)
(605) 232-8802
Entity
Organization

Contact information

Practice address
101 MERRILL AVE., NORTH SIOUX CITY, SD 57049
(605) 232-8802
(605) 232-0973
Mailing address
101 MERRILL AVE., PO BOX 1010, NORTH SIOUX CITY, SD 57049
(605) 232-8802
(605) 232-0973

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M847
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0722009
IA
05
0989517
IA
Enumeration date
02/08/2007
Last updated
08/22/2020
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