# SAGEBRUSH DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SageBrush Dental LLC, SageBrush Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619434552
- **Authorized official:** ERICH JURGES DDS (DENTIST)
- **Authorized official phone:** (509) 436-8202

## Contact information

- **Practice address:** 1114 N MISSION ST STE A, WENATCHEE, WA 98801-6711
- **Practice address phone:** (509) 436-8202
- **Mailing address:** 1114 N MISSION ST STE A, WENATCHEE, WA 98801-6711
- **Mailing address phone:** (509) 436-8202

## Taxonomy

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

## Other

- **Enumeration date:** 02/27/2019
- **Last updated:** 05/28/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1942650049 | MEDICARE/ MEDICAID NOT ACCEPTED | WA |