Provider Demographics
NPI:1215544333
Name:BLACK HILLS SLEEP & TMJ SOLUTIONS
Entity Type:Organization
Organization Name:BLACK HILLS SLEEP & TMJ SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-718-0155
Mailing Address - Street 1:2001 HOPE CT STE 4
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-1055
Mailing Address - Country:US
Mailing Address - Phone:605-718-0155
Mailing Address - Fax:605-626-8568
Practice Address - Street 1:2001 HOPE CT STE 4
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-1055
Practice Address - Country:US
Practice Address - Phone:605-718-0155
Practice Address - Fax:605-626-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty