| Dba Wilson Park Dental | |
|
807 Saint Andrew St Rapid City SD 57701-4526 | |
| (605) 343-9352 | |
| Not Available |
| Full Name | Dba Wilson Park Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 807 Saint Andrew St, Rapid City, South Dakota |
| Authorized Official Name and Position | Chris M Maltaverne (OFFICE MANAGER) |
| Authorized Official Contact | 6053439352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Wilson Park Dental 807 Saint Andrew St Rapid City SD 57701-4526 Ph: (605) 343-9352 | Dba Wilson Park Dental 807 Saint Andrew St Rapid City SD 57701-4526 Ph: (605) 343-9352 |
| NPI Number | 1871830851 |
|---|---|
| Provider Enumeration Date | 01/10/2013 |
| Last Update Date | 01/10/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871830851 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D0812 (South Dakota) | Primary |
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