Provider Demographics
NPI:1275685299
Name:KASSUBE & LANKFORD MIDWEST PERIODONTICS, PROF. LLC
Entity Type:Organization
Organization Name:KASSUBE & LANKFORD MIDWEST PERIODONTICS, PROF. LLC
Other - Org Name:KASSUBE AND LANKFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-335-8830
Mailing Address - Street 1:3805 S KIWANIS CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4266
Mailing Address - Country:US
Mailing Address - Phone:605-335-8830
Mailing Address - Fax:605-335-0947
Practice Address - Street 1:3805 S KIWANIS CIR
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-4266
Practice Address - Country:US
Practice Address - Phone:605-335-8830
Practice Address - Fax:605-335-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty