Individual
BRIAN T WISWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
518 N SYCAMORE AVENUE, SIOUX FALLS, SD 57110-5737
(605) 373-0245
(605) 336-3261
Mailing address
518 N SYCAMORE AVENUE, SIOUX FALLS, SD 57110-5737
(605) 373-0245
(605) 336-3261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M446
SD
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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