Individual
MASON ALEXANDER HERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2606 ELDERBERRY BLVD STE 1, RAPID CITY, SD 57703-5981
(605) 737-3150
Mailing address
2606 ELDERBERRY BLVD STE 1, RAPID CITY, SD 57703-5981
(605) 737-3150
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D1453
SD
Other
Enumeration date
06/24/2024
Last updated
06/25/2024
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