Healthcare Provider Details

I. General information

NPI: 1992879191
Provider Name (Legal Business Name): CENTRAL DAKOTA EAR, NOSE & THROAT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 S LLOYD ST SUITE E106
ABERDEEN SD
57401-4552
US

IV. Provider business mailing address

201 S LLOYD ST SUITE E106
ABERDEEN SD
57401-4552
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-1420
  • Fax: 605-225-3307
Mailing address:
  • Phone: 605-225-1420
  • Fax: 605-225-3307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0383
License Number StateSD

VIII. Authorized Official

Name: DR. ROBERT A CIHAK
Title or Position: OWNER
Credential: M.D.
Phone: 605-225-1420