Organization
ORTHODONTICS OF THE BLACK HILLS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS L JOHNSON DDS, MSD (PRESIDENT)
(605) 663-4865
Entity
Organization
Contact information
Practice address
2525 W MAIN ST STE 206, RAPID CITY, SD 57702-2439
(605) 663-4865
Mailing address
2525 W MAIN ST STE 206, RAPID CITY, SD 57702-2439
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/01/2022
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