Cheyenne River Dental Clinic
NPI #1851422596 in Eagle Butte, South Dakota
Provider Information
- NPI Number
- 1851422596
- Entity Type
- Organization
- Organization Name
- Cheyenne River Dental Clinic
- Primary Specialty
- Dentist - Dental Public Health
- Enumeration Date
- Mar 7, 2007
- Last Updated
- Aug 5, 2022
Practice Location
- Address
- 24276 166TH ST
- City
- Eagle Butte
- State
- South Dakota
- ZIP Code
- 57625-8141
- Phone
- (605) 964-0736
Authorized Official
- Name
- MRS. TIFFANY L LARSON
- Title
- CRST DENTAL ADMINISTRATIVE MANAGER
- Phone
- (605) 964-0736
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Dental Public Health — Dental Public Health |
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