Healthcare Provider Details

I. General information

NPI: 1508847054
Provider Name (Legal Business Name): DRS DARIN AND HALLY BACH DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 05/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 4TH ST NE SUITE 207
WATERTOWN SD
57201-1898
US

IV. Provider business mailing address

600 4TH ST NE SUITE 207
WATERTOWN SD
57201-1898
US

V. Phone/Fax

Practice location:
  • Phone: 605-882-0747
  • Fax: 605-882-2196
Mailing address:
  • Phone: 605-882-0747
  • Fax: 605-882-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. DARIN M. BACH
Title or Position: OWNER
Credential: D.D.S.
Phone: 605-882-0747