Organization
BLACK HILLS MODERN ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC P WILBUR MDM (OWNER)
(605) 791-5900
Entity
Organization
Contact information
Practice address
655 OMAHA ST STE 400, RAPID CITY, SD 57701-2744
(605) 791-5900
Mailing address
655 OMAHA ST STE 400, RAPID CITY, SD 57701-2744
(605) 791-5900
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2019
Last updated
12/04/2019
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