Provider Demographics
NPI:1265866586
Name:DAROLD D OPP DDS PC
Entity Type:Organization
Organization Name:DAROLD D OPP DDS PC
Other - Org Name:CENTER FOR ADVANCED DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAROLD
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:OPP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-225-2236
Mailing Address - Street 1:1409 6TH AVE SE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4950
Mailing Address - Country:US
Mailing Address - Phone:605-225-2236
Mailing Address - Fax:605-225-8952
Practice Address - Street 1:1409 6TH AVE SE
Practice Address - Street 2:SUITE 8
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4950
Practice Address - Country:US
Practice Address - Phone:605-225-2236
Practice Address - Fax:605-225-8952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAROLD D OPP DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty