Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Black Hills Oral & Maxillofacial Surgery PC

Organization Oral and Maxillofacial Pathology Dentistry · NPI 1063486926

Black Hills Oral & Maxillofacial Surgery PC is an Oral and Maxillofacial Pathology Dentistry in Rapid City, South Dakota. Licensed in South Dakota. Registered with an NPI since 2006.

Licensed in
SD
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3415 5th St
Rapid City, SD 57701-7365
Phone: (605) 348-6818
Fax: (605) 348-4690
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Pathology Dentistry (primary) Taxonomy 1223P0106X · Licence M367 (SD)

Record details

NPI number1063486926
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Roger Wilson — President · (605) 348-6818
NPI enumeratedFebruary 15, 2006
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 5690, Rapid City, SD 57709-5690

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