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General NPI Number Information
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NPI Number | 1093671794
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Entity Type | Individual
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Provider Name | EMILEE GOLDY
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Gender | Female
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Dates
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Enumeration Date | 12/27/2025
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 1761 TABLEROCK RD
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City | RAPID CITY
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State | SD
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Zip | 57701-5595
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Country | US
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Telephone | 605-721-1111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1557
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City | RAPID CITY
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State | SD
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Zip | 57709-1557
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH1999
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License Number State | SD
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