Healthcare Provider Details

I. General information

NPI: 1285552117
Provider Name (Legal Business Name): DYLAN ANDREW KRUGER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 3RD ST
RAPID CITY SD
57701-7374
US

IV. Provider business mailing address

2800 3RD ST
RAPID CITY SD
57701-7374
US

V. Phone/Fax

Practice location:
  • Phone: 605-341-2000
  • Fax: 605-341-0278
Mailing address:
  • Phone: 605-341-2000
  • Fax: 605-341-0278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number843
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: