# JEFFREY S. WITHUSKI & PAULA SABBE DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154585594
- **Authorized official:** DR. JEFFREY S WITHUSKI DDS (OWNER)
- **Authorized official phone:** (701) 642-8566

## Contact information

- **Practice address:** 103 9TH ST N STE 2, WAHPETON, ND 58075-4343
- **Practice address phone:** (701) 642-8566
- **Practice address fax:** (701) 642-1111
- **Mailing address:** 103 9TH ST N STE 2, WAHPETON, ND 58075-4343
- **Mailing address phone:** (701) 642-8566
- **Mailing address fax:** (701) 642-1111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2008
- **Last updated:** 07/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1807 | BCBS | — |
| 05 | — | 41107 | — | ND |
| 01 | — | 984022200 | MINNESOTA MEDICAL ASSISTANCE | ND |