| Black Hills Endodontics | |
|
2525 W Main St Suite 206 Rapid City SD 57702-0901 | |
| (605) 348-4868 | |
| (605) 737-7870 |
| Full Name | Black Hills Endodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 2525 W Main St, Rapid City, South Dakota |
| Authorized Official Name and Position | Lyde J Adams (PRES/CEO) |
| Authorized Official Contact | 6053484868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Endodontics 2525 W Main St Suite 206 Rapid City SD 57702-0901 Ph: (605) 348-4868 | Black Hills Endodontics 2525 W Main St Suite 206 Rapid City SD 57702-0901 Ph: (605) 348-4868 |
| NPI Number | 1720416506 |
|---|---|
| Provider Enumeration Date | 10/14/2013 |
| Last Update Date | 07/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720416506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | D1012 (South Dakota) | Primary |
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