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General NPI Number Information
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NPI Number | 1609849165
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Entity Type | Organization
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Legal Business Name | DAKOTA HILLS FAMILY PRACTICE
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1010 BALLPARK RD SUITE 2
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City | STURGIS
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State | SD
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Zip | 57785-2364
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Country | US
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Telephone | 605-720-1389
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Fax |
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Provider Business Mailing Address
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Address Line | 30321 ROOSEVELT CT
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City | STURGIS
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State | SD
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Zip | 57785-6903
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DAVID LAUER
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Credential |
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Telephone | 605-720-1389
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 1247
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License Number State | SD
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