Provider Demographics
NPI:1245592112
Name:DRS DARIN AND HALLY BACH DDS PC
Entity Type:Organization
Organization Name:DRS DARIN AND HALLY BACH DDS PC
Other - Org Name:DAKOTA CENTER FOR DENTAL SLEEP MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, FAGD
Authorized Official - Phone:800-996-7352
Mailing Address - Street 1:600 4TH ST NE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-1898
Mailing Address - Country:US
Mailing Address - Phone:800-996-7352
Mailing Address - Fax:605-882-2196
Practice Address - Street 1:2315 W 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5041
Practice Address - Country:US
Practice Address - Phone:800-996-7352
Practice Address - Fax:605-882-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-15
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM936122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty