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General NPI Number Information
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NPI Number | 1558744946
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Entity Type | Individual
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Provider Name | MELISSA J RUPERT D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 07/02/2015
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Provider Practice Location Address
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Address Line | 557 E MAIN ST
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City | HILL CITY
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State | SD
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Zip | 57745-8905
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Country | US
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Telephone | 605-574-2161
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Fax | 844-800-1950
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Provider Business Mailing Address
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Address Line | 557 E MAIN ST PO BOX 902
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City | HILL CITY
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State | SD
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Zip | 57745-8905
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Country | US
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Telephone | 605-574-2161
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Fax | 844-800-1950
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | D1086
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License Number State | SD
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