Douglas E Idema, DDS Valid NPI

Individual provider · Dentist · Sioux Falls, SD

NPI

1285709394

Type

Individual (Type 1)

Primary specialty

Dentist

Specialty group

Dental Providers

Taxonomy code

122300000X

License number

M266 (SD)

Sex

Male

Sole proprietor

No

Enumerated

2006-11-22

Last updated

2007-07-08