Brian T Wiswall DDS PC
Dentist, General Practice in Sioux Falls, SD. Organization (NPI-2).
NPI number1497842801
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1497842801
- Entity type
- Organization (NPI-2)
- Legal business name
- Brian T Wiswall DDS PC
- Organization subpart
- No
- Enumeration date
- Oct 6, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | M446 | SD | Yes |
Practice location
518 N Sycamore AvenueSioux Falls, SD 57110-5737
Phone 605-373-0245 · Fax 605-336-3261
Mailing address
518 N Sycamore AvenueSioux Falls, SD 57110-5737
Phone 605-373-0245 · Fax 605-336-3261
Authorized official
Brian T Wiswall
President
6053730245
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