Individual
SARA K REAUSAW-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
4215 BERNIECE ST, RAPID CITY, SD 57703-6410
(605) 343-6691
(605) 343-6731
Mailing address
4215 BERNIECE ST, RAPID CITY, SD 57703-6410
(605) 343-6691
(605) 343-6731
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D0819
SD
Other
Enumeration date
04/10/2008
Last updated
05/26/2016
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