Provider Demographics
NPI:1982310918
Name:WATERTOWN DENTAL CARE PLLC
Entity Type:Organization
Organization Name:WATERTOWN DENTAL CARE PLLC
Other - Org Name:WATERTOWN DENTAL CARE, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
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 STE 207
Mailing Address - Street 2:
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:
Practice Address - Street 1:2315 W 57TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5046
Practice Address - Country:US
Practice Address - Phone:605-882-0747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WATERTOWN DENTAL CARE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-24
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental