Organization
PRAIRIE SINUS EAR & ALLERGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY D RAISEN MD (OWNER)
(701) 630-0100
Entity
Organization
Contact information
Practice address
3000 N 14TH ST, 3RD FLOOR, BISMARCK, ND 58503-0697
(701) 630-0100
Mailing address
PO BOX 1215, BISMARCK, ND 58502-1215
(701) 630-0100
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
11025
ND
Other
Enumeration date
03/19/2017
Last updated
03/21/2017
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