Organization
EMBRACE 212 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN PROUTY DDS (OWNER)
(605) 886-8394
Entity
Organization
Contact information
Practice address
2300 9TH AVE SE, WATERTOWN, SD 57201-7112
(605) 886-8394
(605) 886-5209
Mailing address
2300 9TH AVE SE, WATERTOWN, SD 57201-7112
(605) 886-8394
(605) 886-5209
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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