| Black Hills Embrace Llc | |
|
4215 Berniece St Rapid City SD 57703-6410 | |
| (605) 343-6691 | |
| Not Available |
| Full Name | Black Hills Embrace Llc |
|---|---|
| Speciality | Dentist |
| Location | 4215 Berniece St, Rapid City, South Dakota |
| Authorized Official Name and Position | Brian Kelly Prouty (OWNER) |
| Authorized Official Contact | 0568780456 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Embrace Llc 4215 Berniece St Rapid City SD 57703-6410 Ph: (605) 343-6691 | Black Hills Embrace Llc 4215 Berniece St Rapid City SD 57703-6410 Ph: (605) 343-6691 |
| NPI Number | 1134725922 |
|---|---|
| Provider Enumeration Date | 12/08/2020 |
| Last Update Date | 12/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134725922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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