Organization
JEFFREY S. WITHUSKI & PAULA SABBE DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY S WITHUSKI DDS (OWNER)
(701) 642-8566
Entity
Organization
Contact information
Practice address
103 9TH ST N STE 2, WAHPETON, ND 58075-4343
(701) 642-8566
(701) 642-1111
Mailing address
103 9TH ST N STE 2, WAHPETON, ND 58075-4343
(701) 642-8566
(701) 642-1111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1807
BCBS
—
05
—
41107
—
ND
01
—
984022200
MINNESOTA MEDICAL ASSISTANCE
ND
Enumeration date
07/15/2008
Last updated
07/15/2008
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