| Mary K. Roth D.d.s. Pc | |
|
807 Saint Andrew St Rapid City SD 57701-4526 | |
| (605) 343-9352 | |
| (605) 343-3115 |
| Full Name | Mary K. Roth D.d.s. Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 807 Saint Andrew St, Rapid City, South Dakota |
| Authorized Official Name and Position | Mary Kay Roth (DOCTER) |
| Authorized Official Contact | 6053439352 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary K. Roth D.d.s. Pc 807 Saint Andrew St Rapid City SD 57701-4526 Ph: (605) 343-9352 | Mary K. Roth D.d.s. Pc 807 Saint Andrew St Rapid City SD 57701-4526 Ph: (605) 343-9352 |
| NPI Number | 1699976902 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 06/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699976902 | NPI | - | NPPES |
| 7805870 | Medicaid | SD | |
| BR1122302 | Other | SD | OTHER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | M697 (South Dakota) | Primary |
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