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General NPI Number Information
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NPI Number | 1821373325
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Entity Type | Individual
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Provider Name | JOSHUA WADE NEHRING D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/15/2011
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 2800 JACKSON BLVD SUITE #6
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City | RAPID CITY
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State | SD
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Zip | 57702-1504
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Country | US
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Telephone | 605-348-2556
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 JACKSON BLVD
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City | RAPID CITY
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State | SD
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Zip | 57702-1504
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Country | US
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Telephone | 605-348-2556
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 8063149-9921
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | D1040
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License Number State | SD
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