Provider Demographics
NPI:1770369183
Name:BISMARCK HEARING PLLC
Entity type:Organization
Organization Name:BISMARCK HEARING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:701-391-6951
Mailing Address - Street 1:3831 LOCKPORT ST STE C
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-5539
Mailing Address - Country:US
Mailing Address - Phone:701-751-2500
Mailing Address - Fax:701-751-0231
Practice Address - Street 1:3831 LOCKPORT ST STE C
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-5539
Practice Address - Country:US
Practice Address - Phone:701-751-2500
Practice Address - Fax:701-751-0231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty