Provider Demographics
NPI:1003168568
Name:AESCHLIMANN PEDIATRIC DENTISTRY, INC.
Entity type:Organization
Organization Name:AESCHLIMANN PEDIATRIC DENTISTRY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AESCHLIMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-275-5771
Mailing Address - Street 1:27966 452ND AVE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:SD
Mailing Address - Zip Code:57053-6003
Mailing Address - Country:US
Mailing Address - Phone:605-275-5221
Mailing Address - Fax:605-275-5772
Practice Address - Street 1:6908 S. LYNCREST PL.
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108
Practice Address - Country:US
Practice Address - Phone:605-275-5771
Practice Address - Fax:605-275-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No126800000XDental ProvidersDental AssistantGroup - Multi-Specialty