Organization
PEDIATRIC DENTISTRY PC
Active
Other names
DBA. Dunes Dental 4 Kids
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE S. HANSEN (OFFICE MANAGER)
(605) 242-4700
Entity
Organization
Contact information
Practice address
711 SIOUX POINT RD. STE. 100, DAKOTA DUNES, SD 57049-5099
(605) 242-4700
(605) 242-4702
Mailing address
711 SIOUX POINT RD. STE. 100, DAKOTA DUNES, SD 57049-5099
(605) 242-4700
(605) 242-4702
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
M991
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0234450
—
IA
Enumeration date
03/11/2014
Last updated
11/18/2016
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