Healthcare Provider Details

I. General information

NPI: 1366561326
Provider Name (Legal Business Name): BRIAN RICHARD SATHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3508 S MINNESOTA AVE SUITE #108
SIOUX FALLS SD
57105-6461
US

IV. Provider business mailing address

3508 S MINNESOTA AVE SUITE #108
SIOUX FALLS SD
57105-6461
US

V. Phone/Fax

Practice location:
  • Phone: 605-339-1381
  • Fax:
Mailing address:
  • Phone: 605-339-1381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberM420
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: