Provider Demographics
NPI:1801935499
Name:MENTELE, DAVID ANTHONY (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTHONY
Last Name:MENTELE
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Gender:M
Credentials:PHARMACIST
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Mailing Address - Street 1:4413 E 36TH ST
Mailing Address - Street 2:DAVID MENTELE
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103
Mailing Address - Country:US
Mailing Address - Phone:605-747-3235
Mailing Address - Fax:605-747-2216
Practice Address - Street 1:ROSEBUD IHS HOSPITAL
Practice Address - Street 2:SOLDIER CREEK ROAD
Practice Address - City:ROSEBUD
Practice Address - State:SD
Practice Address - Zip Code:57570
Practice Address - Country:US
Practice Address - Phone:605-747-3235
Practice Address - Fax:605-747-2216
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
SD4723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist