SIOUXLAND ORAL SURGERY NPI 1790757011

NPI Information

SIOUXLAND ORAL SURGERY is an oral and maxillofacial surgery dentist in Sioux Falls, SD. The provider is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SIOUXLAND ORAL SURGERY NPI is 1790757011. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6401 S MINNESOTA AVE
SIOUX FALLS, SD
ZIP 57108-504
Phone: (605) 335-1080
Fax: (605) 332-4550

The provider's authorized official is Peggy Kristin Roth .
The authorized official title is Insurance Administrator and has the following contact phone number (605) 335-1080.

The CLIA number assigned to this NPI record is 43D1068722 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2006 and was last updated on 4/14/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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