Provider Demographics
NPI:1093077992
Name:DWCNP, LLC
Entity Type:Organization
Organization Name:DWCNP, LLC
Other - Org Name:DENTON COMBS CENTER FOR EXCELLENCE IN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:DENTON
Authorized Official - Middle Name:
Authorized Official - Last Name:COMBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-231-0403
Mailing Address - Street 1:5124 S WESTERN AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5047
Mailing Address - Country:US
Mailing Address - Phone:605-274-3898
Mailing Address - Fax:605-274-3899
Practice Address - Street 1:5124 S WESTERN AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5047
Practice Address - Country:US
Practice Address - Phone:605-274-3898
Practice Address - Fax:605-274-3899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS105372EFFMedicare PIN