Jeffrey Herbert Wiswall
Endodontist
2525 W Main St Ste 307
Rapid City
, South Dakota 57702-2443
Jeffrey Herbert Wiswall
Endodontist
2525 W Main St Ste 307
Rapid City
, South Dakota 57702-2443
(605) 716-3546
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About
Features
Specialties
- Endodontist
Languages spoken
- English
Location
First Address
- Jeffrey Herbert Wiswall
- 2525 W Main St Ste 307
- Rapid City, SD
- Zip : 57702-2443
- Phone : (605) 716-3546
Second Address
- Jeffrey Herbert Wiswall
- 2525 W Main St Ste 307
- Rapid City, SD
- Zip : 57702-2443
- Phone : (605) 716-3546
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223E0200X | Endodontist | M967 | SD |
National Provider Identifier
| NPI | 1063592160 |
|---|---|
| Provider Name | Jeffrey Herbert Wiswall |
| First Address | Rapid City, SD 57702-2443 |
| Second Address | Rapid City, SD 57702-2443 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/10/2006 |
| Last Update Date | 03/03/2011 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.