Individual
DR. GAYLE REARDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3305 SOUTH LINCOLN AVENUE, SIOUX FALLS, SD 57105-5224
(605) 336-8144
(605) 335-3568
Mailing address
3305 SOUTH LINCOLN AVENUE, SIOUX FALLS, SD 57105-5224
(605) 336-8144
(605) 335-3568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
M518
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D8755
MINNESOTA LIC #
SD
01
—
M518
SOUTH DAKOTA LIC #
SD
Enumeration date
04/19/2007
Last updated
07/08/2007
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