Ponderosa Smiles
NPI #1053919506 in Rapid City, South Dakota
Provider Information
- NPI Number
- 1053919506
- Entity Type
- Organization
- Organization Name
- Ponderosa Smiles
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Oct 15, 2020
- Last Updated
- Oct 15, 2020
Practice Location
- Address
- 5955 MOUNT RUSHMORE RD STE A
- City
- Rapid City
- State
- South Dakota
- ZIP Code
- 57701-8960
- Phone
- (605) 791-5005
Authorized Official
- Name
- ROB LYONS
- Title
- DENTIST
- Phone
- (605) 791-5005
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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