| Northern Plains Oral And Maxillofacial Surgery Llc | |
|
820 1st Ave Se Suite 400 Aberdeen SD 57401-4601 | |
| (605) 225-9362 | |
| (605) 229-7317 |
| Full Name | Northern Plains Oral And Maxillofacial Surgery Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 820 1st Ave Se, Aberdeen, South Dakota |
| Authorized Official Name and Position | Carl M Kimbler (OWNER) |
| Authorized Official Contact | 6052259362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northern Plains Oral And Maxillofacial Surgery Llc 820 1st Ave Se Suite 400 Aberdeen SD 57401-4601 Ph: (605) 225-9362 | Northern Plains Oral And Maxillofacial Surgery Llc 820 1st Ave Se Suite 400 Aberdeen SD 57401-4601 Ph: (605) 225-9362 |
| NPI Number | 1487718565 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 03/25/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487718565 | NPI | - | NPPES |
| 8000400 | Medicaid | SD | |
| 0006084 | Other | SD | BLUE CROSS |
| 41240 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | M862 (South Dakota) | Primary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | SD4237 (South Dakota) | Secondary |
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