| Ponderosa Smiles | |
|
5955 Mount Rushmore Rd Ste A Rapid City SD 57701-8960 | |
| (605) 791-5005 | |
| Not Available |
| Full Name | Ponderosa Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5955 Mount Rushmore Rd Ste A, Rapid City, South Dakota |
| Authorized Official Name and Position | Rob Lyons (DENTIST) |
| Authorized Official Contact | 6057915005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Smiles 5955 Mount Rushmore Rd Ste A Rapid City SD 57701-8960 Ph: (605) 791-5005 | Ponderosa Smiles 5955 Mount Rushmore Rd Ste A Rapid City SD 57701-8960 Ph: (605) 791-5005 |
| NPI Number | 1053919506 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 10/15/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053919506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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