MEDICARE: BH DENTURES LLC

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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1386338770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BH DENTURES LLC

Provider Business Mailing Address
First Line	:	3090 BLACK OAK PL
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-5803
Country	:	US
Telephone Number	:	651-261-1518
Fax Number	:	605-593-0710

Provider Business Practice Location Address
First Line	:	719 OMAHA ST
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-2761
Country	:	US
Telephone Number	:	605-593-0999
Fax Number	:	605-593-0710

Authorized Official
Title or Position	:	OWNER DENTIST
Name	:	DR. AUSTIN PAUL SCHMALZ
Credential	:	DDS
Telephone Number	:	651-261-1518

Provider Enumeration Date	:	06/07/2023
Last Update Date	:	06/07/2023

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Directions to “BH DENTURES LLC ” Practice Location

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