| Black Hills Modern Endodontics | |
|
655 Omaha St Ste 400 Rapid City SD 57701-2744 | |
| (605) 791-5900 | |
| Not Available |
| Full Name | Black Hills Modern Endodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 655 Omaha St Ste 400, Rapid City, South Dakota |
| Authorized Official Name and Position | Eric P Wilbur (OWNER) |
| Authorized Official Contact | 6057915900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Hills Modern Endodontics 655 Omaha St Ste 400 Rapid City SD 57701-2744 Ph: (605) 791-5900 | Black Hills Modern Endodontics 655 Omaha St Ste 400 Rapid City SD 57701-2744 Ph: (605) 791-5900 |
| NPI Number | 1508403957 |
|---|---|
| Provider Enumeration Date | 12/04/2019 |
| Last Update Date | 12/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508403957 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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