| Black Hills Oral & Maxillofacial Surgery Pc | |
|
3415 5th St Rapid City SD 57701-7365 | |
| (605) 348-6818 | |
| (605) 348-4690 |
| Full Name | Black Hills Oral & Maxillofacial Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 3415 5th St, Rapid City, South Dakota |
| Authorized Official Name and Position | Roger Cave Wilson (PRESIDENT) |
| Authorized Official Contact | 6053486818 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Oral & Maxillofacial Surgery Pc Po Box 5690 Rapid City SD 57709-5690 Ph: (605) 348-6818 | Black Hills Oral & Maxillofacial Surgery Pc 3415 5th St Rapid City SD 57701-7365 Ph: (605) 348-6818 |
| NPI Number | 1063486926 |
|---|---|
| Provider Enumeration Date | 02/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063486926 | NPI | - | NPPES |
| 8000140 | Medicaid | SD | |
| 8000050 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | M367 (South Dakota) | Primary |
Dakota Regional Periodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 Jackson Blvd #6, Rapid City, SD 57702 Phone: 605-348-2556 Fax: 605-348-1526 | |
Nelson Dental & Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1611 Sheridan Lake Rd, Rapid City, SD 57702 Phone: 605-341-3670 | |
Evans Orthodontics Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 Dakota Drive, Rapid City, SD 57702 Phone: 605-342-7777 Fax: 605-342-2275 | |
Carl R. Stonecipher Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 Jackson Blvd, Suite 9, Rapid City, SD 57702 Phone: 605-348-0831 Fax: 605-348-0602 | |
Lyde J. Adams, D.d.s. Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2525 W Main St, Ste # 206, Rapid City, SD 57702 Phone: 605-348-4868 Fax: 605-737-7870 | |
Dakota Dental 4 Kids Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5509 Bendt Dr Ste 302, Rapid City, SD 57702 Phone: 605-342-5995 | |
Brian G. Criss Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 720 Sheridan Lake Rd, Rapid City, SD 57702 Phone: 605-342-6652 Fax: 605-342-6656 |