Provider First Line Business Practice Location Address:
1700 S. SOUTHEASTERN AVE.
Provider Second Line Business Practice Location Address:
RIVER RIDGE ORAL AND MAXILLOFACIAL SURGICAL CENTER
Provider Business Practice Location Address City Name:
SIOUX FALLS
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-331-5059
Provider Business Practice Location Address Fax Number:
605-275-6725
Provider Enumeration Date:
03/29/2007