Organization
SIOUXLAND DENTAL HEALTH - SOUTH SIOUX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONEL MCCOMBS (CREDENTIALING SPECIALIST)
(502) 254-8500
Entity
Organization
Contact information
Practice address
2600 CORNHUSKER DR, SOUTH SIOUX CITY, NE 68776-3905
(402) 494-2692
(402) 494-2701
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(502) 254-8500
(502) 245-5021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/09/2013
Last updated
01/09/2013
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