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General NPI Number Information
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NPI Number | 1578479242
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Entity Type | Organization
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Legal Business Name | WILEN DENTISTRY PLLC
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 2640 JACKSON BLVD STE 1
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City | RAPID CITY
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State | SD
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Zip | 57702-3400
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Country | US
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Telephone | 605-642-7760
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 JACKSON BLVD STE 1
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City | RAPID CITY
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State | SD
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Zip | 57702-3400
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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 | OWNER
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Name | BRYCE WILEN
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Credential |
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Telephone | 605-967-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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