Individual
DR. STEVEN FREDERICK WISWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
703 QUINCY ST STE 2, RAPID CITY, SD 57701-3674
(605) 868-6422
Mailing address
13170 BRIDGE LN, RAPID CITY, SD 57702-8523
(605) 868-6422
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
D1070
SD
Other
Enumeration date
07/22/2013
Last updated
03/17/2023
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