Provider Demographics
NPI:1992879191
Name:CENTRAL DAKOTA EAR, NOSE & THROAT
Entity type:Organization
Organization Name:CENTRAL DAKOTA EAR, NOSE & THROAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CIHAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:605-225-1420
Mailing Address - Street 1:201 S LLOYD ST
Mailing Address - Street 2:SUITE E106
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-4552
Mailing Address - Country:US
Mailing Address - Phone:605-225-1420
Mailing Address - Fax:605-225-3307
Practice Address - Street 1:201 S LLOYD ST
Practice Address - Street 2:SUITE E106
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-4552
Practice Address - Country:US
Practice Address - Phone:605-225-1420
Practice Address - Fax:605-225-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0383207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty