| Summit Endodontics | |
|
703 Quincy St Ste 2 Rapid City SD 57701-3674 | |
| (605) 868-6422 | |
| Not Available |
| Full Name | Summit Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 703 Quincy St Ste 2, Rapid City, South Dakota |
| Authorized Official Name and Position | Steven Frederick Wiswall (PRESIDENT) |
| Authorized Official Contact | 6058686422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Endodontics 13170 Bridge Ln Rapid City SD 57702-8523 Ph: (605) 868-6422 | Summit Endodontics 703 Quincy St Ste 2 Rapid City SD 57701-3674 Ph: (605) 868-6422 |
| NPI Number | 1902512163 |
|---|---|
| Provider Enumeration Date | 01/30/2023 |
| Last Update Date | 01/30/2023 |
| Certification Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902512163 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Primary |
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