Organization
SODERSTROM IMPLANT DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L. SODERSTROM DDS (PRESIDENT)
(605) 388-0930
Entity
Organization
Contact information
Practice address
907 JACKSON BLVD, RAPID CITY, SD 57702-2541
(605) 388-0930
(605) 388-0929
Mailing address
907 JACKSON BLVD, RAPID CITY, SD 57702-2541
(605) 388-0930
(605) 388-0929
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M537
SD
Other
Enumeration date
04/10/2007
Last updated
08/22/2020
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