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General NPI Number Information
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NPI Number | 1972506939
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Entity Type | Organization
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Legal Business Name | DAKOTA SURGICAL LTD
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 911 E 20TH ST STE 300
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1045
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Country | US
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Telephone | 605-334-2266
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Fax | 605-322-7675
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Provider Business Mailing Address
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Address Line | 911 E 20TH ST STE 300
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1045
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Country | US
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Telephone | 605-334-2266
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Fax | 605-322-7675
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Authorized Official
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Title or Position | CEO
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Name | DR. FREDERICK L HARRIS
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Credential | MD, MS, FACS
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Telephone | 605-334-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 40865
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License Number State | SD
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