Organization
BRIAN T WISWALL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN T WISWALL DDS (PRESIDENT)
(605) 373-0245
Entity
Organization
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
08/22/2020
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