Individual
DR. ROGER CAVE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3415 5TH ST, RAPID CITY, SD 57701-7365
(605) 348-6818
(605) 348-4690
Mailing address
3415 5TH ST, RAPID CITY, SD 57701-7365
(605) 348-6818
(605) 348-4690
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
M367
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8000050
—
SD
Enumeration date
02/27/2006
Last updated
11/27/2007
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