Provider Demographics
NPI:1508847054
Name:DRS DARIN AND HALLY BACH DDS PC
Entity Type:Organization
Organization Name:DRS DARIN AND HALLY BACH DDS PC
Other - Org Name:WATERTOWN DENTAL CARE
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
Authorized Official - Phone:605-882-0747
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:605-882-0747
Mailing Address - Fax:605-882-2196
Practice Address - Street 1:600 4TH ST NE
Practice Address - Street 2:SUITE 207
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-1898
Practice Address - Country:US
Practice Address - Phone:605-882-0747
Practice Address - Fax:605-882-2196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty