Healthcare Provider Details

I. General information

NPI: 1679483523
Provider Name (Legal Business Name): REESE ALAN BLACKER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 IOWA AVE SE STE 102
HURON SD
57350-2859
US

IV. Provider business mailing address

530 IOWA AVE SE STE 102
HURON SD
57350-2859
US

V. Phone/Fax

Practice location:
  • Phone: 605-352-8753
  • Fax:
Mailing address:
  • Phone: 605-352-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD1537
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: