OrganizationActive
Black Hills Oral & Maxillofacial Surgery PC
NPI 1063486926 · Oral and Maxillofacial Pathology Dentistry · Rapid City, SD
Provider details
- NPI number
- 1063486926
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Pathology DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Roger Wilson, President(605) 348-6818
- License
- M367 (SD)
Specialties & taxonomies
Dental Providers
Practice location
3415 5th St
Rapid City, SD 57701-7365
Phone: (605) 348-6818
Fax: (605) 348-4690
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 5690
Rapid City, SD 57709-5690
Registry dates
- Enumerated
- 2006-02-15
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.