Healthcare Provider Details

I. General information

NPI: 1871592030
Provider Name (Legal Business Name): DAKOTA PLAINS SURGICAL LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 06/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 8TH AVE NW
ABERDEEN SD
57401-1803
US

IV. Provider business mailing address

701 8TH AVE NW
ABERDEEN SD
57401-1803
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-3300
  • Fax: 605-225-3877
Mailing address:
  • Phone: 605-225-3300
  • Fax: 605-225-3877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number10584
License Number StateSD

VIII. Authorized Official

Name: MRS. DEB PEDERSON
Title or Position: DIRECTOR OF NURSING
Credential: RN
Phone: 605-226-9706