Provider Demographics
NPI:1003993544
Name:ABERDEEN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:ABERDEEN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:HODGSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-225-0261
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-1186
Mailing Address - Country:US
Mailing Address - Phone:605-225-0261
Mailing Address - Fax:605-225-5305
Practice Address - Street 1:216 SE 6TH AVE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-6148
Practice Address - Country:US
Practice Address - Phone:605-225-0261
Practice Address - Fax:605-225-5305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental