Provider Demographics
NPI:1376681502
Name:YSETH, STEVE R (DDS PC)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:R
Last Name:YSETH
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:DR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:YSETH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:415 16TH AVE CIRCLE NE
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-0427
Mailing Address - Country:US
Mailing Address - Phone:605-886-2222
Mailing Address - Fax:605-884-0674
Practice Address - Street 1:415 16TH AVE CIRCLE NE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-0427
Practice Address - Country:US
Practice Address - Phone:605-886-2222
Practice Address - Fax:605-884-0674
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM682122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist