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NPI Code Detail

MEDICARE: MS. M BROOKE ANDERSON SAUNDERS DDS

MEDICARE: MS. M BROOKE ANDERSON SAUNDERS 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
1122300000XDentistD0616SD

General Provider Information

NPI Number : 1386757797
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. M BROOKE ANDERSON SAUNDERS DDS
Provider Business Mailing Address
First Line : 6634 SAHALEE DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-6962
Country : US
Telephone Number : 605-209-5236
Fax Number :
Provider Business Practice Location Address
First Line : 3712 CANYON LAKE DR
Second Line :
City : RAPID CITY
State : SD
Zip : 57702-3198
Country : US
Telephone Number : 605-342-3939
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2006
Last Update Date : 03/01/2024

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