Organization
BLACK HILLS ORTHODONTICS, PROF. L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DANA D.D.S. (VICE PRESIDENT/ORTHODONTIST)
(605) 343-1500
Entity
Organization
Contact information
Practice address
2620 JACKSON BLVD STE A, RAPID CITY, SD 57702-3478
(605) 343-1500
Mailing address
2620 JACKSON BLVD STE A, RAPID CITY, SD 57702-3478
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/10/2008
Last updated
03/02/2021
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