MEDICARE: SHARON RENEE FIX DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	M728	SD

General Provider Information

NPI Number	:	1356441422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON RENEE FIX DDS

Provider Business Mailing Address
First Line	:	101 S CLEVELAND AVE
Second Line	:	SUITE 1
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-2034
Country	:	US
Telephone Number	:	605-338-8151
Fax Number	:	605-338-5542

Provider Business Practice Location Address
First Line	:	101 S CLEVELAND AVE
Second Line	:	SUITE 1
City	:	SIOUX FALLS
State	:	SD
Zip	:	57103-2034
Country	:	US
Telephone Number	:	605-338-8151
Fax Number	:	605-338-5542

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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