Collin C. Palmquist DDS, PC

Key facts

NPI

1194903567

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

License

DO609 (SD)

Legal business name

COLLIN C. PALMQUIST DDS, PC

Practice address

600 4TH St NE
Suite 201
Watertown, SD 57201-1898

Phone

(605) 886-8096

Fax

(605) 886-1979

NPI assigned

Feb 7, 2008

Organization subpart

No

Authorized official

Name

Tina Lynn Heller

Title

Office Manager

Phone

(605) 886-8096

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Collin C Palmquist, D.D.S. Dentist · Watertown, SD · NPI 1285757658
  NPD GENERAL PRACTICE
• Sydney Ebben-Carmody, DDS Dentist · Watertown, SD · NPI 1487357000
  NPD (past) GENERAL PRACTICE

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 26, 2008.

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1194903567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011898",
            "telephone_number": "605-886-8096",
            "fax_number": "605-886-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 4TH ST NE",
            "address_2": "SUITE 201",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572011898",
            "telephone_number": "605-886-8096",
            "fax_number": "605-886-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIN C. PALMQUIST DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-07",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "HELLER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "605-886-8096"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "DO609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7809990",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Watertown, SD · General Practice Dentistry in South Dakota