Organization
JACKSON BOULEVARD DENTAL ASSOCIATES
Active
Other names
Taylor Dental
Organization subpart
No
Provider details
NPI number
Authorized official
JARED L TAYLOR DMD (OWNER)
(605) 348-1712
Entity
Organization
Contact information
Practice address
2620 JACKSON BLVD, SUITE B, RAPID CITY, SD 57702-1502
(605) 348-1712
(605) 716-7529
Mailing address
2620 JACKSON BLVD, SUITE B, RAPID CITY, SD 57702-1502
(605) 348-1712
(605) 716-7529
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D1002
SD
122300000X
Dentist
Primary
M636
SD
Other
Enumeration date
01/07/2013
Last updated
10/13/2021
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