Provider Demographics
NPI:1639574601
Name:S. WILLIAM ROCKINO, DDS
Entity Type:Organization
Organization Name:S. WILLIAM ROCKINO, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ROCKINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-847-4600
Mailing Address - Street 1:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:LAKE PRESTON
Mailing Address - State:SD
Mailing Address - Zip Code:57249-0485
Mailing Address - Country:US
Mailing Address - Phone:605-847-4600
Mailing Address - Fax:
Practice Address - Street 1:105 3RD ST NE
Practice Address - Street 2:
Practice Address - City:LAKE PRESTON
Practice Address - State:SD
Practice Address - Zip Code:57249
Practice Address - Country:US
Practice Address - Phone:605-847-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-03
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDM377261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental