Healthcare Provider Details

I. General information

NPI: 1184559478
Provider Name (Legal Business Name): THE CORNERSTONE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8030 S CINNAMON RIDGE PL
SIOUX FALLS SD
57108-6466
US

IV. Provider business mailing address

8030 S CINNAMON RIDGE PL
SIOUX FALLS SD
57108-6466
US

V. Phone/Fax

Practice location:
  • Phone: 605-413-6510
  • Fax:
Mailing address:
  • Phone: 605-413-6510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: TANNER DAVIS ROBBINS
Title or Position: DIRECTOR
Credential:
Phone: 605-951-7692