Organization
WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC
Active
Parent organization
WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC
Other names
Prairie Skies Family Dentristry
Organization subpart
Yes
Provider details
NPI number
Legal business name
WISEMAN & TIDSTROM DENTAL MANAGEMENT, LLC
Authorized official
ERIK WISEMAN D.D.S. (DENTIST / OWNER)
(605) 692-9555
Entity
Organization
Contact information
Practice address
420 FRONT STREET, BROOKINGS, SD 57006
(605) 692-9555
(605) 692-0967
Mailing address
420 FRONT STREET, BROOKINGS, SD 57006
(605) 692-9555
(605) 692-0967
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D0624
SD
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
03/02/2017
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