MEDICARE: DAKOTA HILLS FAMILY PRACTICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1770504326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAKOTA HILLS FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	1010 BALLPARK RD
Second Line	:	SUITE 3
City	:	STURGIS
State	:	SD
Zip	:	57785-2364
Country	:	US
Telephone Number	:	605-720-1389
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 BALLPARK RD
Second Line	:	SUITE 3
City	:	STURGIS
State	:	SD
Zip	:	57785-2364
Country	:	US
Telephone Number	:	605-720-1389
Fax Number	:

Authorized Official
Title or Position	:	ADM ASSISTANT
Name	:	KELLY D LESTER
Credential	:
Telephone Number	:	605-642-8414

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/22/2020

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