| East Ridge Dental | |
|
518 N Sycamore Ave Sioux Falls SD 57110-5737 | |
| (605) 373-0245 | |
| (605) 336-3261 |
| Full Name | East Ridge Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 518 N Sycamore Ave, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Ryon Robert Reckling (OWNER, DENTIST) |
| Authorized Official Contact | 6053730245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East Ridge Dental 518 N Sycamore Ave Sioux Falls SD 57110-5737 Ph: (605) 373-0245 | East Ridge Dental 518 N Sycamore Ave Sioux Falls SD 57110-5737 Ph: (605) 373-0245 |
| NPI Number | 1508628751 |
|---|---|
| Provider Enumeration Date | 01/24/2024 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508628751 | NPI | - | NPPES |
| 1073860128 | Other | SD | INDIVIDUAL NPI |
| 1407235229 | Other | SD | INDIVIDUAL NPI |
| 1437756905 | Other | SD | CORPORATION |
| 1841362266 | Other | SD | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | () | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | () | Secondary |
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