Healthcare Provider Details

I. General information

NPI: 1366375156
Provider Name (Legal Business Name): EMBRACE FIRST CLASS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6703 S LOUISE AVE
SIOUX FALLS SD
57108-5982
US

IV. Provider business mailing address

6703 S LOUISE AVE
SIOUX FALLS SD
57108-5982
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-9330
  • Fax:
Mailing address:
  • Phone: 605-271-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: COLTON PRYOR
Title or Position: COO
Credential:
Phone: 605-431-4296