Provider Demographics
NPI:1831435650
Name:DAY FAMILY DENTISTRY, LLC
Entity type:Organization
Organization Name:DAY FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:BLY
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-448-5977
Mailing Address - Street 1:701 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRITTON
Mailing Address - State:SD
Mailing Address - Zip Code:57430-2279
Mailing Address - Country:US
Mailing Address - Phone:605-448-5977
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:605-448-5977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD0940122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty