| Black Hills Area Dental | |
|
200 Federal Ave Rapid City SD 57702-2326 | |
| (605) 348-4657 | |
| Not Available |
| Full Name | Black Hills Area Dental |
|---|---|
| Speciality | Dentist |
| Location | 200 Federal Ave, Rapid City, South Dakota |
| Authorized Official Name and Position | Bart A Samuelson (OWNER DENTIST PRESIDENT) |
| Authorized Official Contact | 6053484657 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Area Dental 200 Federal Ave Rapid City SD 57702-2326 Ph: (605) 348-4657 | Black Hills Area Dental 200 Federal Ave Rapid City SD 57702-2326 Ph: (605) 348-4657 |
| NPI Number | 1851593164 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851593164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D0607 (South Dakota) | Primary |
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