Organization
ADVANCED FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY W SEGRIST DDS (PRESIDENT)
(605) 716-7509
Entity
Organization
Contact information
Practice address
1801 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-4564
(605) 716-7509
(605) 716-7799
Mailing address
1801 MOUNT RUSHMORE RD, RAPID CITY, SD 57701-4564
(605) 716-7509
(605) 716-7799
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M960
SD
Other
Enumeration date
09/27/2006
Last updated
08/22/2020
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