Organization
IMPLANT & SEDATION DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KELLY PROUTY DDS (OWNER)
(605) 275-2009
Entity
Organization
Contact information
Practice address
3409 W 47TH ST STE 103, SIOUX FALLS, SD 57106-6339
(605) 275-2009
(605) 886-5209
Mailing address
2300 9TH AVE SE, WATERTOWN, SD 57201-7112
(605) 275-2009
(605) 886-5209
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
SD
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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