Organization
RENEW DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JADE KOCH DDS (DENTIST)
(402) 741-0545
Entity
Organization
Contact information
Practice address
6301 W 41ST ST, SIOUX FALLS, SD 57106-1217
(402) 741-0545
Mailing address
6301 W 41ST ST, SIOUX FALLS, SD 57106-1217
(402) 741-0545
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/27/2024
Last updated
09/27/2024
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