| Custer Dental Studio | |
|
141 N 5th St Custer SD 57730-1528 | |
| (605) 321-2086 | |
| Not Available |
| Full Name | Custer Dental Studio |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 141 N 5th St, Custer, South Dakota |
| Authorized Official Name and Position | Kari Bolen (PRESIDENT BOLEN DENTAL PC) |
| Authorized Official Contact | 6052616488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Custer Dental Studio 141 N 5th St Custer SD 57730-1528 Ph: (605) 261-6488 | Custer Dental Studio 141 N 5th St Custer SD 57730-1528 Ph: (605) 321-2086 |
| NPI Number | 1659962595 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 05/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659962595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Dba/ Destination Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 141 N 5th St, Custer, SD 57730 Phone: 605-673-2011 |