| NPI | 1346849478 |
|---|---|
| Doing Business As | ADVANCED ENT AND ALLERGY CENTER OF THE BLACK HILLS, PROF LLC |
| Entity Type | Organization |
| Authorized Contact | JAY WARREN WHITE Owner 605-716-6390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2021-02-08 |