Rushmore Dental

LBN: Timothy L Kelly Dental Prof. Llc
Rushmore Dental is an health care organization with primary practice located at 1600 Mountain View Rd Ste 104 , Rapid City SD 57702-4354. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Timothy L Kelly Dental Prof. Llc can be contacted via phone (605) 593-0037, or through Kelly, Timothy Lynn via phone (605) 593-0037.

Contact Information

Primary practice address
1600 Mountain View Rd Ste 104 Rapid City SD 57702-4354
Phone: (605) 593-0037
Fax: (605) 593-8351
Website:
Map and Directions
Authorized official contact:
Name: Kelly, Timothy Lynn Doctor of Dental Surgery (DDS)
Phone: (605) 593-0037

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D0505 South Dakota

Profile Details

NPI number 1710433123
LBN Legal business name Timothy L Kelly Dental Prof. Llc
DBA Doing business as Rushmore Dental
Authorized official Kelly, Timothy Lynn Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 27th, 2016
Last updated Aug 27th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710433123 NPPES
South Dakota MEDICAID 1588653281

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