Individual
CODY LONNIE HENRIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1729 S CLIFF AVE, SIOUX FALLS, SD 57105-2126
(605) 339-1369
(605) 334-5590
Mailing address
1729 S CLIFF AVE, SIOUX FALLS, SD 57105-2126
(605) 339-1369
(605) 334-5590
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
TEMP 336
SD
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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