DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACKSON BOULEVARD DENTAL ASSOCIATES

Active Organization

JACKSON BOULEVARD DENTAL ASSOCIATES is a Dentist organization located in RAPID CITY, South Dakota. NPI 1629315932 is currently active in the NPPES registry. Verify at CMS.

Dentist · RAPID CITY, SD

Registration Details

NPI Number
1629315932
Provider Type
Organization
NPI Issued
Jan 7, 2013 (13.610206107462 yrs)
Last Updated
Oct 13, 2021
Licenses
D1002 (SD)
M636 (SD)

Practice Information

Address
2620 JACKSON BLVD
SUITE B
RAPID CITY, SD, 577021502
Browse SD providers · Browse ZIP 57702
Phone
6053481712
Fax
6057167529
Primary Specialty
Dentist
122300000X
Additional Specialty
Dentist

Other Dentist Organizations in RAPID CITY, SD

Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.