Provider Demographics
NPI:1558873950
Name:COMPOUND DENTAL OF BRITTON INC
Entity Type:Organization
Organization Name:COMPOUND DENTAL OF BRITTON INC
Other - Org Name:BRITTON DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SHAREHOLDER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:MELVIN
Authorized Official - Last Name:MAIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-380-1953
Mailing Address - Street 1:PO BOX 1420
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57402-1420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:701 MAIN ST
Practice Address - Street 2:
Practice Address - City:BRITTON
Practice Address - State:SD
Practice Address - Zip Code:57430-2279
Practice Address - Country:US
Practice Address - Phone:605-448-5222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD11651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty