Damien Eric Lawhorn, RDH

Individual provider Active NPI Dental Hygienist · Pine Ridge, SD

NPI 1154862068 · NPPES record last updated Mar 10, 2017

Key facts

NPI
1154862068
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
DH3623 (NM)
Practice address
East Hwy 18
Pine Ridge, SD 57770-1201
Phone
(605) 867-3078
Fax
(605) 867-3229
NPI assigned
Mar 10, 2017
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DH3623NMMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH3623 NM Yes

Addresses

Primary practice location

East Hwy 18
Pine Ridge, SD 57770-1201

Mailing address

PO Box 1201
Pine Ridge, SD 57770-1201
Phone (605) 867-3078

Other providers in Pine Ridge, SD

All providers in Pine Ridge, SD · Dental Hygienist in South Dakota

Sources for this page

Verify at the official NPI Registry.