DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC

MEDICARE: BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0106XOral and Maxillofacial Pathology DentistryM367SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063486926
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC
Provider Business Mailing Address
First Line : PO BOX 5690
Second Line :
City : RAPID CITY
State : SD
Zip : 57709-5690
Country : US
Telephone Number : 605-348-6818
Fax Number : 605-348-4690
Provider Business Practice Location Address
First Line : 3415 5TH ST
Second Line :
City : RAPID CITY
State : SD
Zip : 57701-7365
Country : US
Telephone Number : 605-348-6818
Fax Number : 605-348-4690
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROGER CAVE WILSON
Credential : DDS, MS
Telephone Number : 605-348-6818
Provider Enumeration Date : 02/15/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1407836992 — SCOTT D VAN DAM DDS, MD
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax:
1437125721 — DR. ROGER CAVE WILSON DDS, MS
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax: 605-348-4690
1558315838 — DR. JAY ALAN CROSSLAND DDS
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax: 605-348-4690
1194972877 — DR. ISAAC JOHN MORGAN DMD
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax: 605-348-4690
1841517521 — DR. BRIAN R RICHMAN DDS
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax: 605-348-4690
1205176401 — DR. CODY CHRISTENSEN D.D.S.
Practice Location Address:
3415 5TH ST
RAPID CITY, SD
57701-7365
Practice Phone: 605-348-6818
Practice Fax:

Directions to “BLACK HILLS ORAL & MAXILLOFACIAL SURGERY PC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.