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General NPI Number Information
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NPI Number | 1225161383
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Entity Type | Organization
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Legal Business Name | AMANN & GRASLIE DDS, PC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 830 N MAIN ST SUITE 2
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City | SPEARFISH
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State | SD
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Zip | 57783-2184
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Country | US
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Telephone | 605-642-2644
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Fax | 605-722-0057
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Provider Business Mailing Address
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Address Line | 830 N MAIN ST SUITE 2
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City | SPEARFISH
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State | SD
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Zip | 57783-2184
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Country | US
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Telephone | 605-642-2644
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Fax | 605-722-0057
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY AMANN
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Credential | DDS
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Telephone | 605-642-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State | SD
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